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Unrelated Donor Transplants

Unrelated bone marrow transplantation in children: outcome and a comparison with sibling donor grafting

Bone Marrow Transplantation volume 25, pages 1059–1065 (2000)Cite this article

Abstract

The clinical course of 59 children, who underwent BMT during 1988–1998 with a matched unrelated donor (MUD), was compared with 59 case controls receiving a sibling donor marrow. Thirty-eight patients had haematological malignancies while 21 had a nonmalignant disorder. The cumulative incidence of acute GVHD grade II–IV was 28% for MUD recipients vs 11% (P = 0.014) for sibling recipients. Extensive chronic GVHD was rare in both groups. The 5-year probability of survival was 52% for MUD vs 77% for sibling recipients (P = 0.014). For children with malignancies the 4-year probability of survival was 52% for MUD vs 67% for sibling recipients with a RFS of 49% vs 62%. In the ALL patients the survival of the MUD recipients was 77% and equalled that of the sibling group. For SAA survival was 43% vs 86% (P = 0.09) and for metabolic disorders 63% vs 89% (P = 0.025). The transplant-related mortality was higher in the MUD group, while death due to relapse was equally distributed. These results of MUD BMT in children compare favourably with most previous reports, and support the use of alternative donors in cases who lack an HLA-identical siblings. Bone Marrow Transplantation (2000) 25, 1059–1065.

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Acknowledgements

The project was supported by grants from The Swedish Children's Cancer Foundation, the Samariten Foundation, the Swedish Cancer Society (0070-B97–11XBC), the Swedish Medical Research Council (K98–06x-05971–18B), Ellen Bachrach Foundation and the Tobias Foundation.

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Authors and Affiliations

  1. Department of Paediatrics Transplantation, Karolinska Institutet, Huddinge University Hospital, Huddinge, Sweden

    Å Gustafsson & J Winiarski

  2. Centre for Allogeneic Stem Cell Transplantation, Karolinska Institutet, Huddinge University Hospital, Huddinge, Sweden

    Å Gustafsson, M Remberger, J Winiarski & O Ringdén

  3. Department of Clinical Immunology Transplantation, Karolinska Institutet, Huddinge University Hospital, Huddinge, Sweden

    M Remberger & O Ringdén

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  1. Å Gustafsson
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Gustafsson, Å., Remberger, M., Winiarski, J. et al. Unrelated bone marrow transplantation in children: outcome and a comparison with sibling donor grafting. Bone Marrow Transplant 25, 1059–1065 (2000). https://doi.org/10.1038/sj.bmt.1702400

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