Parvovirus B19 (PVB19) induced severe aplastic anaemia (SAA) or myelodysplastic syndrome (MDS) is rare, and haematopoietic stem cell transplantation (HSCT) in this condition has not been reported so far. 6 children with SAA (n=4) or MDS (n=2) caused by acute PVB19 infection underwent HSCT under the protection of intravenous immunoglobulines. The 4 children with SAA received matched HLA bone marrow from a sibling (n=3) or peripheral unrelated blood stem cells (n=1). 1 patient had delayed erythrocyte engraftment, whereas 3 patients had an uneventful transplantation course. HSCT in one of the 2 children with MDS was complicated by poor graft function, the other patient engrafted without complications. In conclusion, HSCT in children with PVB19 induced SAA or MDS is feasible, even though some patients may develop delayed engraftment or prolonged poor graft function. Parvovirus-B19(PVB19)-induzierte aplastische Anämien (SAA) oder myelodysplastische Syndrome (MDS) sind selten. Bei 6 Kindern (SAA: n=4; MDS: n=2) wurde unter i.v. IgG-Schutz eine HSCT durchgeführt. 4 Kinder mit SAA erhielten Knochenmark HLA-identer Geschwister (n=3) oder unverwandte periphere Blutstammzellen (n=1); bei 1 Patient kam es zu einem verzögerten Erythrozytenengraftment. Bei einem der beiden Kinder mit MDS zeigte sich nach HSCT aufgrund einer schlechten Transplantatfunktion ein komplizierter Verlauf, bei dem zweiten Patienten kam es zu einem komplikationslosen Engraftment. Zusammenfassend ist eine HSCT bei Kindern mit PVB19 induzierter SAA oder MSD durchführbar, auch wenn es in manchen Fällen zu einem verzögerten Engraftment oder schlechter Transplantatfunktion kommen kann.

Evans syndrome (ES) is a chronic hematological disorder characterized by autoimmune hemolytic anemia and immune-mediated thrombocytopenia that often requires profound and long-term immunosuppression. Only a few small case series or single case studies of autologous and allogeneic hematopoietic stem cell transplantation (HSCT) in patients with ES have been reported in the literature, with long-term remissions being observed after both autologous and allogeneic HSCT. Patients with ES suffering from refractory disease, multiple relapses and serious disease-related complications should be offered allogeneic HSCT, which is the only treatment with curative potential. Autologous HSCT might be preferable in patients with serious pre-existing comorbidities lacking an HLA-identical donor. Owing to the rarity of this disease and the small number of patients receiving HSCT for ES, prospective controlled studies on this approach are not available. A prospective registration of patients transplanted for ES would allow the development of optimal transplant strategies.