title: Unrelated donor marrow transplantation: an update of the experience of the Italian Bone Marrow Group (GITMO).
abstract: OBJECTIVE
  Unrelated donor bone marrow transplant (UD-BMT) has become an attractive alternative source of hematopoietic cells for patients lacking a matched sibling. The aim of this paper was to report on results of the 696 UD BMTs performed in 31 Italian institutions during the first 10 years of activity of the Italian Bone Marrow Donor Registry (IBMDR).
  
  
  METHODS
  In 1989 the Italian Bone Marrow Transplant Group (GITMO) established the IBMDR to facilitate donor search and marrow procurement for patients lacking an HLA identical sibling. By end of December 1999, 260,000 HLA-A, B typed volunteer donors had been cumulatively registered and 2,620 searches had been activated for Italian patients. At least one HLA-A, B, DRB1 matched donor was found for 54% of the patients and 696 UD BMTs were performed. In 50% of cases the donor was found in the IBMDR and in 50% in 15 other Registries. The average time from search activation to transplant was 6 months for disease other than CML. For CML it was 14 months. Actuarial 12-month transplant-related mortality (TRM) was 68% in patients grafted between 1979 and 1992 and 44% for patients grafted after 1993. Twenty-eight per cent of patients developed grade III or IV acute GvHD and 24% developed extensive chronic GvHD. The rate of disease free survival at three years was 57% for patients with 1st chronic phase CML, 37% for patients with 1st or 2nd CR ALL, 31% for AML or MDS patients 18 years of age and 54% for patients with inborn errors.
  
  
  CONCLUSIONS
  We conclude that the IBMDR has benefited a substantial number of patients lacking a matched sibling and has facilitated the recruitment of UDs into the international donor pool. The long time required for the search is the major obstacle to the success of this programme. This suggests that early transplant and a decrease in TRM could further improve these encouraging results.
authors: Department of Pediatric Hematology and Oncology, G. Gaslini Children's Hospital, l.go G. Gaslini 5, 16148 Genoa, Italy. giorgiodini@ospedale-gaslini.ge.it
authors: G
authors: G
authors: Dini
authors: R
authors: R
authors: Cancedda
authors: F
authors: F
authors: Locatelli
authors: A
authors: A
authors: Bosi
authors: G
authors: G
authors: Bandini
authors: E P
authors: EP
authors: Alessandrino
authors: F
authors: F
authors: Porta
authors: C
authors: C
authors: Uderzo
authors: C
authors: C
authors: Messina
authors: F
authors: F
authors: Fagioli
authors: W
authors: W
authors: Arcese
authors: P
authors: P
authors: Marenco
authors: R
authors: R
authors: Fanin
authors: M
authors: M
authors: Falda
authors: D
authors: D
authors: Soligo
authors: G
authors: G
authors: La Nasa
authors: C
authors: C
authors: Giardini
authors: A
authors: A
authors: Pession
authors: R
authors: R
authors: Scimè
authors: P
authors: P
authors: Di Bartolomeo
authors: B
authors: B
authors: Bruno
authors: L
authors: L
authors: Garbarino
authors: T
authors: T
authors: Lamparelli
authors: G
authors: G
authors: Giorgiani
authors: E
authors: E
authors: Lanino
authors: C
authors: C
authors: Manzitti
authors: A
authors: A
authors: Bacigalupo
mesh_terms: D000293:Adolescent; D000328:Adult; D000741:Anemia, Aplastic / Q000628:therapy; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D002648:Child; D002675:Child, Preschool; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications / Q000401:mortality / Q000628:therapy; D006648:Histocompatibility; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D014019:Tissue Donors; D014184:Transplantation, Homologous / Q000009:adverse effects / Q000379:methods / Q000592:standards