Antiphospholid antibody syndrome and Hb E/Beta thalassemia disease post-allogeneic stem cell transplantation.

We report a 10-year-old male with Hb E/Beta thalassemia disease who developed chronic graft-versus-host disease (cGVHD) of antiphospholipid antibody syndrome after successful allogeneic stem cell transplantation (SCT). He exhibited a recurrent ischemic stroke on day 368 post-SCT while on cyclosporine A, azathioprine, and prednisolone. The immunosuppressive agents were switched to pulse methylprednisolone, tacolimus, mycophenolate mofetil, and enoxaparin, but the patient was more confused. An additional plasma exchange which was aimed at the immediate removal of autoantibody was performed with a good response. The symptoms rapidly disappeared except for the complex partial seizure which persisted until seven years post-SCT.