# Successful third haploidentical hematopoietic stem cell transplantation after two graft failures in a pediatric patient with severe aplastic anemia: a case report with five-year follow-up

## TL;DR

A 3-year-old girl with severe aplastic anemia successfully received a third stem cell transplant after two failures, showing that a haploidentical donor can be a viable option.

## Contribution

This case demonstrates the viability of a third haploidentical HSCT as a salvage therapy after two graft failures in SAA.

## Key findings

- A third haploidentical HSCT successfully achieved engraftment after two graft failures in a pediatric SAA patient.
- The approach extended the patient's survival and provided long-term follow-up data over five years.
- Haploidentical HSCT may serve as an effective salvage therapy for graft failure in SAA.

## Abstract

Hematopoietic stem cell transplantation (HSCT) offers a potentially curative option for severe aplastic anemia (SAA). However, graft failure (GF) remains a life-threatening complication following HSCT. Haploidentical HSCT may serve as an effective salvage therapy for the treatment of GF.

This report describes a 3-year-old girl with acquired SAA who experienced GF twice following matched unrelated donor (MUD) transplantations. Successful engraftment was ultimately achieved through a third haploidentical donor HSCT. This work was conducted in accordance with the Declaration of Helsinki and the Declaration of Istanbul.

Based on our experience with this case, we conclude that a third HSCT with a haploidentical donor represents a viable approach to extending survival.