Syngeneic bone marrow transplantation for treatment of aplastic anaemia: report of a case and review of the literature.

A patient with severe aplastic anaemia achieved restoration of marrow function following marrow transplantation from her identical twin. Sixteen years later both patient and donor are in good health without significant haematologic abnormality. This is the first case of successful syngeneic marrow transplantation reported in China. The success of this procedure, without immunosuppression, suggests that this patient's disease was due to a defect in haemopoietic stem cells rather than in marrow microenvironment. A review of the 23 other patients treated by syngeneic marrow transplantation for aplastic anaemia suggests that approximately one-half have a disease due primarily to a defect in stem cells. Conversely for a patient who does not recover haemopoiesis after syngeneic marrow transplantation a further transplant preceded by immunosuppressive therapy may be curative. No direct correlation between the number of syngeneic marrow cells transfused and the success of the graft can be discerned from the literature.