Following you will find information concerning the various types of donors
that we use for marrow transplantation.
The above graphic indicates the types of donors that we have used for
marrow transplantation over the past 13 years.
Unrelated marrow donors
We are an approved transplant center through the National
Marrow Donor Program (NMDP). The NMDP is a federally funded program
created in 1986 to provide marrow transplants from volunteer donors. The
NMDP coordinates searches among donor and transplant centers throughout
the United States and other countries. It receives requests for bone marrow
donors from these centers, searches the computer registry (containing
over 2.5 million donors) for a match, coordinates additional testing of
donors, and helps with transplantation arrangements. Our program will
accept donors with a mismatch at the A or B antigen, making them a 5/6
match. The ability to accept this type of donor greatly increases our
chances of finding an acceptable donor. We are also able to search the
Iowa Marrow Donor Program registry and Bone
Marrow Donors Worldwide, which includes many international registries.
As of January 1, 2001 we have transplanted 74 patients using an unrelated
donor.
Related marrow donors
When transplanting patients using a family member as donor we have developed
a number of unique protocols which allow us to use less than fully matched
(6/6) donors. The complications from less fully matched transplants are
potentially greater, such as Graft
versus Host Disease(GvHD); therefore, we have developed systems for
managing this. We have also found a number of important benefits from
using such donors in that the time to transplant is much shorter as an
unrelated search is not needed, and there is an increase in the graft
versus leukemia effect, potentially reducing the chance of relapse post-transplant.
As of January 1, 2001 we have transplanted 55 patients using an matched
(6/6) related donor, 55 patients using a partially matched (4/6 or 5/6)
related donor, and 153 patients using a haploidentical (3/6) donor.
Autologous marrow donors
Autologous marrow transplantation involves harvesting bone marrow from
the patient, cryopreserving this, then infusing as you would with any
other marrow, following ablative therapy. Autologous transplants are indicated
only for certain diseases. Some of the benefits of this type of transplant
are that there is no risk of graft rejection or GvHD, and engraftment
is often much quicker. As of January 1, 2001 we have transplanted 17 patients
using autologous marrow.
Autologous peripheral blood stem cell (PBSC) donors
Autologous PBSC transplantation involves harvesting stem cells from the
patient, cryopreserving this, then infusing following ablative therapy.
Using stem cells for hematopoetic reconstitution is a fairly new field
and shows great promise. One of the benefits of this procedure are that
the harvesting of these cells is easier, it is done in the blood bank
not the operating room. As of January 1, 2001 we have transplanted 16
patients using autologous stem cells.
Other donors
There are several additional sources of marrow or stem cells which we
have available.
Allogeneic PBSC transplantation involves using stem cells from either
a related or unrelated donor. Unrelated donors can be obtained through
NMDP or other registries. We have used stem cells from related donors
several times as a boost to patients when engraftment has been slow. We
have used stem cells from both related and unrelated donors to successfully
treat relapse and infection.
Umbilical cord blood
is another potential source of stem cells for transplantation. There
are a number of cord blood banks around the country which provide unrelated
cord blood in a manner similar to that of providing marrow. The
National Marrow Donor Program has incorporated 6 of these banks into their
registry making the searching of these banks even easier. We have
harvest cord blood from related donors (newborn siblings of potential
BMT recipients) for storage and future use. The harvesting of umbilical
cord blood is of no risk to either the mother or the baby; it is carried
out on the placenta after the baby is delivered. As of January 1,
2001 we have transplanted 2 patients using umbilical cord blood.
|
