Syngeneic hematopoietic stem cell transplantation from an identical twin sister in an AML patient: "A case report highlighting accelerated engraftment and reduced transfusion requirements".
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BACKGROUND AND OBJECTIVE: Hematopoietic stem cell transplantation (HSCT) is among the most effective immunotherapeutic strategies for treating hematologic malignancies in both pediatric and adult patients. Its global use has been steadily increasing. Patients undergoing HSCT commonly require transfusion support with blood products until engraftment is achieved, and transfusion requirements can significantly affect post-transplant outcomes. Despite advancements that have improved survival rates, transplant-related mortality (TRM) continues to be a major obstacle to optimal outcomes. CASE PRESENTATION: We present the case of a 46-year-old woman diagnosed with acute myeloid leukemia (AML) harboring an FLT3-ITD mutation, who underwent allogeneic HSCT. The donor was her identical twin sister, with full HLA compatibility (a 10/10 match) and an identical ABO blood group (O positive). Notably, the patient exhibited rapid neutrophil and platelet engraftment by day +9, which is earlier than typically observed in transplants from fully matched related or unrelated donors. Furthermore, the patient did not require any red blood cell or platelet transfusions during the transplantation period and developed no signs of acute or chronic graft-versus-host disease (GVHD). She has remained disease-free with no evidence of relapse for over three years post-transplant. CONCLUSION: HSCT from an identical twin donor may provide favorable clinical outcomes, including accelerated engraftment and reduced transfusion needs during the transplantation process.