Haploidentical hemopoietic cell transplantation (haplo-SCT) is a therapeutic option in patients with acquired severe aplastic anemia (SAA); failure of one course of immune suppressive therapy (IST) with antithymocyte globulin (ATG) and the lack of an HLA-matched related or unrelated donor are accepted criteria for considering haplo-SCT treatment. Prevention of graft-versus-host disease (GvHD) in haplo-SCT is provided both by ex vivo T-cell depletion and by extensive drug GvHD prophylaxis after unmanipulated graft. Haploidentical transplant for IST-refractory SAA is a clinical option offered in centers with established experience in haplo-SCT and should be applied within clinical protocol aimed at maximally preventing graft rejection and GvHD.
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