Marrow transplantation from HLA-matched unrelated donors for treatment of hematologic malignancies.
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.
Beatty
P G
PG
Fred Hutchinson Cancer Research Center, Seattle, Washington.
Hansen
J A
JA
Longton
G M
GM
Thomas
E D
ED
Sanders
J E
JE
Martin
P J
PJ
Bearman
S I
SI
Anasetti
C
C
Petersdorf
E W
EW
Mickelson
E M
EM
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
D006680:HLA Antigens