title: Allogeneic stem cell transplantation for Fanconi Anaemia. Severe Aplastic Anaemia Working Party of the EBMT and EUFAR. European Group for Blood and Marrow Transplantation.
abstract: Fanconi anaemia is a hereditary disorder characterised by chromosomal breaks increased by cross-linking agents. Bone marrow transplantation is the treatment of choice when a HLA identical sibling donor has been identified. The use of low-dose cyclophosphamide with thoraco-abdominal irradiation for the conditioning regimen of FA patients has lead to a dramatic improvement of survival, with a long-term survival of 75% at our institution. However, if most patients are completely cured of their haematological disease, there is concern about an increased frequency of secondary tumours, mostly head and neck squamous cell carcinomas of poor prognosis. Results of BMT using alternative donors (HLA mismatched related and unrelated donors) have also improved during the last decade. A better selection of the donor via high-resolution techniques for class-II HLA matching, and more recently the use of T cell depleted grafts are probably the main explanations. Despite a short follow-up and the small number of patients analysed, transplants using HLA matched family cord blood give some promising results. On the other hand, first results with unrelated cord blood remind that this approach is clearly an experimental one that has to be evaluated through international registries and prospective studies. New approaches including autologous stem cell transplantations and gene therapy are currently explored.
authors.affiliation: Service de Greffe de Moelle, Hôpital Saint-Louis, Paris, France. Phguardiol@aol.com
authors.forename: P
authors.initials: P
authors.lastname: Guardiola
authors.forename: G
authors.initials: G
authors.lastname: Socié
authors.forename: R
authors.initials: R
authors.lastname: Pasquini
authors.forename: I
authors.initials: I
authors.lastname: Dokal
authors.forename: J J
authors.initials: JJ
authors.lastname: Ortega
authors.forename: M
authors.initials: M
authors.lastname: van Weel-Sipman
authors.forename: J
authors.initials: J
authors.lastname: Marsh
authors.forename: F
authors.initials: F
authors.lastname: Locatelli
authors.forename: G
authors.initials: G
authors.lastname: Souillet
authors.forename: J Y
authors.initials: JY
authors.lastname: Cahn
authors.forename: P
authors.initials: P
authors.lastname: Ljungman
authors.forename: R
authors.initials: R
authors.lastname: Miniero
authors.forename: J
authors.initials: J
authors.lastname: Shaw
authors.forename: C
authors.initials: C
authors.lastname: Vermylen
authors.forename: E
authors.initials: E
authors.lastname: Archimbaud
authors.forename: A N
authors.initials: AN
authors.lastname: Bekassy
authors.forename: G
authors.initials: G
authors.lastname: Krivan
authors.forename: P
authors.initials: P
authors.lastname: Di Bartolomeo
authors.forename: A
authors.initials: A
authors.lastname: Bacigalupo
authors.forename: E
authors.initials: E
authors.lastname: Gluckman
mesh_terms: D005199:Fanconi Anemia / Q000628:therapy*; D005312:Fetal Blood / Q000166:cytology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D014184:Transplantation, Homologous