allogeneic hematopoietic stem cell transplantation (Assistance publique - Hôpitaux de Paris)

This allogeneic hematopoietic stem cell transplantation (HSCT) protocol, specifically the APARR regimen developed by Assistance Publique - Hôpitaux de Paris, is an optimized therapeutic approach for patients aged 40 to 60 with refractory or relapsed severe aplastic anemia (SAA). The protocol utilizes bone marrow as the primary stem cell source and incorporates a conditioning regimen consisting of anti-thymocyte globulin (Thymoglobulin), fludarabine, pre-transplant cyclophosphamide, and low-dose total body irradiation (2 Gray). To address the high risk of graft-versus-host disease (GvHD) in this older population, the protocol employs post-transplantation cyclophosphamide (PTCy) on days +3 and +4, followed by immunosuppression with tacrolimus and mycophenolate mofetil. This strategy aims to selectively deplete alloreactive T cells while preserving the graft's function and reducing transplant-related mortality.

Other names

allo-HSCTAllogeneic HSCTBone marrow transplantationAPARR protocol