Cyclophosphamide and Anti-thymocyte Globulin Followed By Methotrexate and Cyclosporine in Preventing Chronic Graft-Versus-Host Disease in Patients With Severe Aplastic Anemia Undergoing Donor Bone Marrow Transplant

Exclusion Criteria

• •Severe disease other than aplastic anemia that would severely limit the probability of survival during the graft procedure:
• •* Patients who have developed clonal cytogenetic abnormalities or myelodysplastic syndrome (preleukemia)
• •* Patients with Fanconi's anemia
• •* Aplasia secondary to radiation or cytotoxic chemotherapy
• •* Patients with paroxysmal nocturnal hemoglobinuria who have not developed aplastic anemia
• •Severe organ toxicities:
• •* Cardiac insufficiency requiring treatment or symptomatic coronary artery disease;
• •* Severe hypoxemia , partial pressure of oxygen (pO2) \< 70 mm Hg, with decreased diffusion capacity of carbon monoxide (DLCO) \< 70% of predicted; or mild hypoxemia, pO2 \< 80 mm Hg with severely decreased DLCO \< 60% of predicted;
• •* Impaired renal function (creatinine \> 2 times upper limit of normal or estimated creatinine clearance \< 60 ml/min)
• •Fungal infections with radiological progression after receipt of amphotericin B or active triazole for greater than 1 month
• •Human immunodeficiency virus (HIV)-positive patients
• •Females who are pregnant or breast-feeding
• •DONOR: Donors who have increase anesthetic risk and are not able psychologically and medically to tolerate the procedure
• •DONOR: HIV-positive donors