Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Part I Pathophysiology of acquired aplastic anemia
- Part II Epidemiology and clinical features of acquired aplastic anemia
- Part III Treatment of acquired aplastic anemia
- 9 Supportive treatment of patients with severe aplastic anemia
- 10 Immunosuppressive treatment of aplastic anemia
- 11 Role of cytokines in the treatment of aplastic anemia
- 12 HLA-identical sibling bone marrow transplantation to treat severe aplastic anemia
- 13 Alternative donor bone marrow transplantation for severe acquired aplastic anemia
- 14 Treatment of children with acquired aplastic anemia
- 15 Long-term follow-up of patients with aplastic anemia: clonal malignant and nonmalignant complications
- 16 Guidelines for treating aplastic anemia
- Part IV Fanconi's anemia
- Index
13 - Alternative donor bone marrow transplantation for severe acquired aplastic anemia
from Part III - Treatment of acquired aplastic anemia
Published online by Cambridge University Press: 18 August 2009
- Frontmatter
- Contents
- List of contributors
- Preface
- Part I Pathophysiology of acquired aplastic anemia
- Part II Epidemiology and clinical features of acquired aplastic anemia
- Part III Treatment of acquired aplastic anemia
- 9 Supportive treatment of patients with severe aplastic anemia
- 10 Immunosuppressive treatment of aplastic anemia
- 11 Role of cytokines in the treatment of aplastic anemia
- 12 HLA-identical sibling bone marrow transplantation to treat severe aplastic anemia
- 13 Alternative donor bone marrow transplantation for severe acquired aplastic anemia
- 14 Treatment of children with acquired aplastic anemia
- 15 Long-term follow-up of patients with aplastic anemia: clonal malignant and nonmalignant complications
- 16 Guidelines for treating aplastic anemia
- Part IV Fanconi's anemia
- Index
Summary
Introduction
Severe acquired aplastic anemia (SAA) is the first disease for which HLA-identical sibling bone marrow transplantation (ID-BMT) has been shown by a prospective study to be the preferred treatment (Camitta et al., 1976). In contrast the role of alternative donor BMT in the treatment of the 60–70% of patients with SAA who lack an HLA-identical sibling is not yet established. In this chapter we first briefly review factors that influence the outcome of ID-BMT. Secondly, we review published results of alternative donor BMT, highlighting major problems. Finally we present the results of an analysis of data from the International Bone Marrow Transplant Registry (IBMTR), the European Bone Marrow Transplant Group (EBMT) SAA Working Party, the Fred Hutchinson Cancer Research Center (FHCRC), and the International Marrow Unrelated Search and Transplant (IMUST) Study. From these data we make tentative recommendations for patient, donor and protocol selection for alternative donor BMT for SAA.
Prognostic factors for HLA-identical sibling BMT
ID-BMT results in a 90% probability of the long-term survival of minimally transfused patients (Storb et al., 1980). The probability of graft failure after ID-BMT increases with the number of pretransplant transfusions (Champlin et al., 1989).
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- Information
- Aplastic AnemiaPathophysiology and Treatment, pp. 258 - 274Publisher: Cambridge University PressPrint publication year: 1999
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