title: Marrow transplantation from HLA-matched unrelated donors for treatment of hematologic malignancies.
abstract: Less than 40% of the patients who could benefit from marrow transplantation have an HLA-matched relative who can serve as a donor. For this reason, several centers have explored marrow transplantation from other categories of donors. This retrospective study analyzes the results of marrow transplantation for 52 patients receiving grafts from HLA-A,B,DR,Dw-phenotypically matched, MLC-compatible, unrelated volunteer donors compared to a disease, disease-stage, and age-matched cohort of 104 patients transplanted from HLA-genotypically identical sibling donors. The patients transplanted from unrelated donors had an increased incidence of grade II-IV acute graft-versus-host disease compared to patients transplanted from related donors (79% vs. 36%, P much less than 0.001). However, the probability of relapse-free survival appears similar in the two groups (P = 0.39 over all, with estimates of 41% vs. 46% at 1 year). We conclude from this preliminary data that marrow transplantation from HLA-matched unrelated donors should be considered in most, if not all, circumstances where transplantation from an HLA-matched sibling would be indicated if such a donor were available.
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: P G
authors.initials: PG
authors.lastname: Beatty
authors.forename: J A
authors.initials: JA
authors.lastname: Hansen
authors.forename: G M
authors.initials: GM
authors.lastname: Longton
authors.forename: E D
authors.initials: ED
authors.lastname: Thomas
authors.forename: J E
authors.initials: JE
authors.lastname: Sanders
authors.forename: P J
authors.initials: PJ
authors.lastname: Martin
authors.forename: S I
authors.initials: SI
authors.lastname: Bearman
authors.forename: C
authors.initials: C
authors.lastname: Anasetti
authors.forename: E W
authors.initials: EW
authors.lastname: Petersdorf
authors.forename: E M
authors.initials: EM
authors.lastname: Mickelson
mesh_terms: D000208:Acute Disease; D000328:Adult; D016026:Bone Marrow Transplantation / Q000276:immunology*; D002908:Chronic Disease; D006086:Graft vs Host Disease / Q000276:immunology; D006680:HLA Antigens / Q000032:analysis; D006402:Hematologic Diseases / Q000601:surgery*; D006648:Histocompatibility; D006801:Humans; D012189:Retrospective Studies; D016019:Survival Analysis; D014019:Tissue Donors
chemical_list: D006680:HLA Antigens