Age 23 Years, Aplastic Anemia
Contributed By: Dr Muhammad Farhan, FCPS (Clinical Haem)
Mr. Umair Khan was 23 years of age when he developed progressive pallor. He was initially worked up in Karachi and was diagnosed as a case of very severe Aplastic Anemia. The patient reported to AFBMTC/NIBMT in Jan 2012 and underwent allogeneic bone marrow transplant on 26 Mar 2012 from HLA matched sister. Prior to transplant Mr. Khan has received 30 units of RCC and approximately 30 units of random donor platelets. One year before presentation the patient suffered intraocular bleeding due to injury sustained while playing cricket as a result of which he lost eyesight in his left eye.
Pretransplant work up revealed no comorbidity and good functional status. There was no ABO mismatch. The patient received conditioning with Fludarabine 120 mg/m, Cyclophosphamide 120 mg/kg and ATG (rabbit) 20/kg over 4 days. He received both bone marrow harvest (TNC dose 2.9 x 10 /kg) and PBSC harvest (MNC dose of 1.7 x 8 10 /kg). Engraftment was prompt with neutrophil engraftment was on day +11 and that of platelets on day +14. There was no major complication and except for initial azotemia (max creatinine 202 µmol/l) the patient remained well. There was no acute graft versus host disease.
Three months after transplant Mr. Khan went back to Karachi and his follow up was handed over to a local consultant. Immunosuppression was tapered off one year post transplant, followed by vaccination.
Mr. Khan has recently married and last month he visited us along with his wife. They were on honeymoon trip to northern areas. Mr. Khan looked well and is leading an active life. He works at a managerial post in a private company. We wish a very happy and prosperous life to the newly married couple.