新兴国家获得性再生障碍性贫血 (AA) 的管理取决于可用的预后分层、治疗和后勤手段。在法语国家骨髓移植和细胞治疗协会 (SFGM-TC) 第 13 届年度协调研讨会上，指定工作组审查了文献，以制定针对该疾病的同种异体造血细胞移植 (Allo-HCT) 的统一指南。结合实践，得出以下结论：抗鼓膜细胞球蛋白(ATG)的使用主要来自兔，很少来自马。骨髓移植、全身照射和国际无关供体登记的机会有限，这证明了使用外周血干细胞、基于化疗的调理和相关替代供体的合理性。研讨会建议对所有年龄小于 40 岁、患有严重或极严重 AA 的患者进行匹配的同级异基因 HCT。对于年龄超过 40 岁或缺乏 HLA 一致供体的患者，建议使用环孢素、马 ATG、艾曲波帕或环孢素、艾曲波帕联合治疗。如果没有马 ATG 和艾曲波帕，则匹配的同胞同种异体 HCT 可能适合作为年龄在 40-60 岁之间且体能状态良好的患者的一线治疗。尽管如此，对于免疫抑制治疗和血小板生成素激动剂失败的患者，以及在没有 HLA 匹配供体的情况下，建议采用改良巴尔的摩条件的单倍体同种异体 HCT。版权所有 © 2024 Société Française du Cancer。由 Elsevier Masson SAS 出版。版权所有。

Management of acquired aplastic anemia (AA) in emerging countries depends on the means of prognostic stratification, treatment and logistics available. During the 13th annual harmonization workshop of the francophone Society of bone marrow transplantation and cellular therapy (SFGM-TC), a designated working group reviewed the literature in order to elaborate unified guidelines for allogeneic hematopoietic cell transplantation (Allo-HCT) in this disease. In terms of practice, the conclusions are as follows; The use of anti-tymocyte globuline (ATG) is mainly from rabbit and very little from horse. Access to bone marrow graft, total body irradiation, and the international unrelated donor registries is limited, which justifies the use of peripheral blood stem cells, chemotherapy-based conditioning, and related alternative donor. The workshop recommends matched sibling allo-HCT in all patients aged less than 40 years with acquired severe or very severe AA. For patients aged over than 40 years, or who lack an HLA-identical donor, treatment with the combination of cyclosporin, horse ATG, eltrombopag or cyclosporine, eltrombopag is recommended. If horse ATG and eltrombopag are not available, matched sibling allo-HCT may be indicated as first-line therapy in patients aged between 40-60 years, and good performance status. Although, in patients who have failed immunosuppressive treatments and thrombopoietin agonists, and in the absence of HLA-matched donor, a haplo-identical allo-HCT with modified Baltimore conditioning is recommended.Copyright © 2024 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.