 | COOLEY'S ANEMIA: SEVENTH SYMPOSIUM
Copyright © 1998 by the New York Academy of Sciences
description
Annals of the New York Academy of Sciences 850:312-324 (1998)
© 1998 New York Academy of Sciences
Unrelated and HLA-Nonidentical Related Donor Marrow Transplantation forThalassemia and Leukemia: A Combined Report from the Seattle Marrow Transplant Team and the International Bone Marrow Transplant Registrya
K. M. SULLIVANb-d,
C. ANASETTIc,d,
M. HOROWITZe,
P. A. ROWLINGSe,
E. W. PETERSDORFc,d,
P. J. MARTINc,d,
R. A. CLIFTc,
M. C. WALTERSc,d,
T. GOOLEYc,
J. SIERRAc,
J. E. ANDERSONc,d,
J. BJERKEc,
M. SIADAKc,
M. E. D. FLOWERSc,
R. A. NASHc,d,
J. E. SANDERSc,d,
F. R. APPELBAUMc,d,
R. STORBc,d AND
J. A. HANSENc,d
cFred Hutchinson Cancer Research Center, Seattle, Washington, USA
dUniversity of Washington School of Medicine, Seattle, Washington, USA
eInternational Bone Marrow Transplant Registry and the Medical College of Wisconsin, Milwaukee, Wisconsin, USA
aThis work supported by Grants AI 2958, AI 33484, AR 39153, CA 18029, CA 18221, CA 40053 and HL 36444 from the National Institutes of Health, Department of Health and Human Services. Additional sponsors of the International Bone Marrow Transplant Registry are listed in the appendix.
bAddress for correspondence: Keith M. Sullivan, M.D., Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., D5-360, P.O. Box 19024, Seattle, WA 98109-1024. Tel: 206/667-4416; Fax: 206/667-2147; E-mail: ksulliva{at}fhcrc.org
Allogeneic marrow transplantation is curative therapy for thalassemia, but fewer than 30% of patients have an HLA-identical sibling marrow donor. Selection of alternative donors of hematopoietic stem cells (unrelated individuals or HLA-nonidentical family members) has been aided by establishment of world-wide donor registries now exceeding 3.6 million volunteers and by DNA-based HLA typing to more closely match potential donors. Coupled with improved methods to control graft-versus-host disease and prevent fungal and cytomegalovirus infection, remarkable progress has been made in alternative donor transplantation. For patients 50 years of age or younger, with recently diagnosed chronic myelogenous leukemia (CML) in chronic phase, 1- and 5-year survivals after HLA-A, B, DRB1 identical unrelated marrow transplantation in Seattle are 82% and 74%, respectively. These results are essentially identical to outcome in similar patients given HLA-matched sibling allografts. However, the world-wide number of alternative donor transplants for thalassemia remains limited to date: 4 unrelated and 60 HLA-nonidentical related transplants have been reported to the IBMTR since 1969 with actuarial overall survival of 75%. Using the paradigm of CML, it is likely that access to curative therapy of thalassemia will improve with optimal HLA typing and donor selection early in the course of disease.
This article has been cited by other articles:
|
|
|
|
 
R. F. Storb, G. Lucarelli, P. A. McSweeney, and R. W. Childs
Hematopoietic Cell Transplantation for Benign Hematological Disorders and Solid Tumors
Hematology,
January 1, 2003;
2003(1):
372 - 397.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. La Nasa, C. Giardini, F. Argiolu, F. Locatelli, M. Arras, P. De Stefano, A. Ledda, A. Pizzati, M. A. Sanna, A. Vacca, et al.
Unrelated donor bone marrow transplantation for thalassemia: the effect of extended haplotypes
Blood,
May 29, 2002;
99(12):
4350 - 4356.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Battaglia, M. Andreani, M. Manna, S. Nesci, P. Tonucci, B. Persini, G. R. della Cuna, A. Nocera, J. Gorski, G. Lucarelli, et al.
Coexistence of Two Functioning T-Cell Repertoires in Healthy Ex-Thalassemics Bearing a Persistent Mixed Chimerism Years After Bone Marrow Transplantation
Blood,
November 15, 1999;
94(10):
3432 - 3438.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
