Relapse of aplastic anemia with majority donor chimerism (donor-type aplasia) occurring late after bone marrow transplantation.

•DTA is recurrent pancytopenia despite sustained majority donor chimerism after BMT for SAA.•Treatment with immunosuppressive therapy or stem cell boosts has not been effective.•Most patients required retransplantation from the same or an alternative donor.•Sibling retransplantation has sometimes been followed by further relapse after many years.•Eltrombopag may be of benefit in some patients.