Flu+CPM+rATG Conditioning Regimes for Unrelated Bone Marrow Transplantation (UBMT)(or Mobilized Peripheral Blood)in Severe Aplastic Anemia (SAA)

Inclusion Criteria:

* Diagnosis of severe aplastic anemia defined by any two or three peripheral blood criteria
* and either marrow criterion.
* Peripheral blood

  1. Neutrophils \< 0.5 x 109/l
  2. Platelets \< 20 x 109/l
  3. Corrected reticulocytes \< 1%
* Bone marrow

  1. Severe hypocellularity (\< 25%)
  2. Moderate hypocellularity (25-30%) with hematopoietic cells representing \< 30% of residual cells
* No prior hematopoietic stem cell transplantation.
* Age: no limits.
* Performance status: ECOG 0-2.
* Patients must be free of significant functional deficits in major organs, but the following eligibility criteria may be modified in individual cases.

  1. Heart: a shortening fraction \> 30%, ejection fraction \> 45%.
  2. Liver: total bilirubin \< 2 × upper limit of normal; ALT \< 3 × upper limit of normal.
  3. Kidney: creatinine \<2 × normal or a creatinine clearance (GFR) \> 60 ml/min/1.73m2.
* Patients must lack any active viral infections or active fungal infection.
* Appropriate donor is available: Matched in 6/6 of A, B, DR loci.
* Patients (or one of parents if patients age \< 19) should sign informed consent.

Exclusion Criteria:

* Pregnant or nursing women.
* Malignant or nonmalignant illness that is uncontrolled or whose control may be jeopardized by complications of study therapy.
* Psychiatric disorder that would preclude compliance.
* Congenital aplastic anemia including Fanconi anemia.
* Manipulated bone marrow.