Marrow transplantation using volunteer unrelated donors in a comparison of mismatched family donor transplants: a Seattle perspective.
Although allogeneic marrow transplantation has evolved into the treatment of choice for many otherwise fatal diseases, most patients are not candidates as they do not have an HLA-matched sibling donor. The Seattle Marrow Transplant Team, among others, has shown that patients who receive grafts from relatives who are partially matched for HLA (5 of 6 HLA-A,-B,-DR antigens) have an increased risk of graft-versus-host disease, but an overall survival that is comparable to that of similar patients receiving grafts from HLA-matched siblings. Similarly, patients receiving grafts from HLA-matched unrelated donors are at high risk for GVHD, but can look forward to favorable outcomes nearly as frequently as those who receive grafts from matched relatives. Grafts from more HLA-disparate donors, either related or unrelated, are at substantially increased risk of complications and death.
Beatty
P G
PG
Bone Marrow Transplant Program, University of Utah School of Medicine, Salt Lake City 84132.
D000328:Adult; D016026:Bone Marrow Transplantation / Q000401:mortality / Q000639:trends; D005190:Family; D005260:Female; D006086:Graft vs Host Disease / Q000453:epidemiology / Q000401:mortality; D006680:HLA Antigens / Q000235:genetics; D006648:Histocompatibility; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012042:Registries; D012306:Risk; D016019:Survival Analysis; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000639:trends; D016896:Treatment Outcome; D014861:Washington
D006680:HLA Antigens