Abstract
We performed an unrelated cord blood stem cell transplantation (CBSCT) for a case with congenital dyserythropoietic anemia. After conditioning with TBI, cyclophosphamide, and cyclosporin A, the CBSCT was done from an HLA 2-locus mismatched male donor. She failed to engraft, but a spontaneous recovery of autologous cells was observed. A second CBSCT from a different HLA 2-locus mismatched donor was carried out 149 days after the first CBSCT. The preparative regimen consisted of ATG, cytarabine, cyclophosphamide, and thiotepa, but engraftment was never observed. It is uncertain why the graft failed in the serial CBSCT because she received intensified preconditioning regimen and enough cord blood cells. It is well known, but our case suggests that one should pay much attention to the higher incidence of graft failure in HLA-mismatched CBSCT.
