Allogeneic hematopoietic stem cell transplantation (Allo-HSCT) from an HLA matched sibling donor is the initial treatment of choice for newly diagnosed patients with severe aplastic anemia. Regarding the graft type, in 2007 The American Society of Hematology published data, indicating that BM grafts are preferred to PBPC grafts in young patients undergoing HLA-matched sibling donor transplantation for SAA. The conditioning regimen In order to improve survival in patients older than 30-40 years, the use of less cytotoxic but more immunosuppressive regimens including low-dose cyclo-phosphamide in combination with ATG, while adding fludarabine (Flu), might be an option. Our study revealed that the use of peripheral stem cell source is still feasible and Fludarabine based conditioning regimen is accepted as it is equivalent to ATG regimens as regards survival, but with maximum attention to supportive care and GVHD prophylaxis and early treatment,with longer term data needed to assess the proper dose of fludarabine.