Autologous Cord Blood Transplantation for Idiopathic Severe Aplastic Anemia

Cord blood units are seldom used for autologous transplantation and selection criteria have not been defined. A 6-year-old male with severe aplastic anemia received an autologous cord blood transplantation containing total nucleated cells (TNC) 2.0×107/kg and CD34+0.32×105/kg. However, he lost the graft and was rescued with a second, haploidentical donor graft. Together with those reported in the literature, 15 children with aplastic anemia received autologous cord blood transplantation. Thirteen children succeeded but 2 failed. Successful transplantation can be predicted by TNC doses of >2.5×107/kg (12/12 vs. 1/3; P=0.029), but not by CD34+ dose or patient's age. Cord blood units with adequate TNC are valid products for autologous transplantation.