title: Twenty years of unrelated donor hematopoietic cell transplantation for adult recipients facilitated by the National Marrow Donor Program.
abstract: For more than 20 years the National Marrow Donor Program has facilitated unrelated donor hematopoietic cell transplants for adult recipients. In this time period, the volunteer donor pool has expanded to nearly 12 million adult donors worldwide, improvements have occurred in the understanding and technology of HLA matching, there have been many changes in clinical practice and supportive care, and the more common graft source has shifted from bone marrow (BM) to peripheral blood stem cells (PBSCs). The percentage of older patients who are receiving unrelated donor transplants is increasing; currently over 1 in 10 adult transplant recipients is over the age of 60 years. Chronic myelogenous leukemia (CML) was previously the most common diagnosis for unrelated donor transplantation, but it now comprises less than 10% of transplants for adult recipients. Transplants for acute myelogenous leukemia (AML), acute lymphoblastic leukemia (ALL), non-Hodgkin lymphoma (NHL), and myelodysplastic syndromes (MDS) all outnumber CML. Treatment-related mortality (TRM) has declined significantly over the years, particularly in association with myeloablative transplant preparative regimens. Correspondingly, survival within each disease category has improved. Particularly gratifying are the results in severe aplastic anemia (AA) where 2-year survival has doubled in just 10 years.
authors: City of Hope National Medical Center, Duarte, California, USA.
authors: Chatchada
authors: C
authors: Karanes
authors: Gene O
authors: GO
authors: Nelson
authors: Pintip
authors: P
authors: Chitphakdithai
authors: Edward
authors: E
authors: Agura
authors: Karen K
authors: KK
authors: Ballen
authors: Charles D
authors: CD
authors: Bolan
authors: David L
authors: DL
authors: Porter
authors: Joseph P
authors: JP
authors: Uberti
authors: Roberta J
authors: RJ
authors: King
authors: Dennis L
authors: DL
authors: Confer
mesh_terms: D000328:Adult; D000368:Aged; D019337:Hematologic Neoplasms / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods / Q000401:mortality; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008875:Middle Aged; D009313:National Health Programs / Q000266:history / Q000458:organization & administration; D012042:Registries; D015996:Survival Rate; D014019:Tissue Donors; D014184:Transplantation, Homologous; D014481:United States