1. ¹Pediatric Immunohematology and Bone Marrow Transplantation Unit, Scientific Institute H S Raffaele, Milan, Italy
2. ²San Raffaele Telethon Institute for Gene Therapy (HSR-TIGET), Milan, Italy
3. ³Vita-Salute San Raffaele University Medical School, Milan, Italy

Correspondence: Dr MG Roncarolo, Pediatric Immunohematology and Bone Marrow Transplantation Unit, Scientific Institute H S Raffaele, via Olgettina 60, Milano 20132, Italy. E-mail: roncarolo.mariagrazia@hsr.it

Received 2 May 2008; Revised 19 May 2008; Accepted 19 May 2008; Published online 23 June 2008.

Abstract

Allogeneic BMT represents the only chance of cure for -thalassemia. Occasionally, two affected individuals from the same family share a matched healthy sibling. Moreover, a high incidence of transplant rejection is still observed in Pesaro class III patients, requiring a second BMT procedure. In these settings, one option is to perform a second BM harvest from the same donor. Although BM harvest is a safe procedure in children, ethical issues concerning this invasive practice still arise. Here, we describe our series of seven pediatric, healthy donors, who donated BM more than once in favor of their -thalassemic HLA-identical siblings between June 2005 and January 2008. Three donors donated BM twice to two affected siblings and four donors donated twice for the same sibling following graft rejection of the first BMT. All donors tolerated the procedures well and no relevant side effects occurred. There was no significant difference between the two harvests concerning cell yield and time to engraftment. Our experience shows that for pediatric donors, a second BM donation is safe and feasible and good cellularity can be obtained. We suggest that a second harvest of a pediatric donor can be performed when a strong indication for BMT exists.