Twenty Years of Unrelated Donor Bone Marrow Transplantation for Pediatric Acute Leukemia Facilitated by the National Marrow Donor Program

Margaret L. MacMillan, Stella M. Davies, Gene O. Nelson, Pintip Chitphakdithai, Dennis L. Confer, Roberta J. King, Nancy A. Kernan

Research output: Contribution to journalEditorial

51 Citations (Scopus)

Abstract

The National Marrow Donor Program (NMDP) has facilitated unrelated donor hematopoietic cell transplants for more than 20 years. In this time period, there have been many changes in clinical practice, including improvements in HLA typing and supportive care, and changes in the source of stem cells. Availability of banked unrelated donor cord blood (incorporated into the NMDP registry in 2000) as a source of stem cells has become an important option for children with leukemia, offering the advantages of immediate availability for children with high-risk disease, the need for a lesser degree of HLA match, and expanding access for those with infrequent HLA haplotypes. Overall survival (OS) in children with acute leukemia transplanted with unrelated donor bone marrow (BM) is markedly better in more recent years, largely attributable to less treatment-related mortality (TRM). Within this cohort, 2-year survival was markedly better for patients with acute lymphoblastic leukemia (ALL) in first complete response (CR1) (74%) versus second complete response (CR2) (62%) or more advanced disease (33%). Similar findings are observed with patients with AML, suggesting earlier referral to bone marrow transplant (BMT) is optimal for survival. Notably, this improvement over time was not observed in unmodified peripheral blood stem cell (PBSC) recipients, suggesting unmodified PBSC may not be the optimal stem cell source for children.

Original languageEnglish (US)
Pages (from-to)16-22
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume14
Issue number9 SUPPL.
DOIs
StatePublished - Sep 1 2008

Fingerprint

Unrelated Donors
Bone Marrow Transplantation
Leukemia
Bone Marrow
Tissue Donors
Pediatrics
Stem Cells
Survival
Transplants
Histocompatibility Testing
Fetal Blood
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Haplotypes
Registries
Referral and Consultation
Mortality
Peripheral Blood Stem Cells
Therapeutics

Keywords

  • Bone marrow transplantation
  • NMDP
  • National Marrow Donor Program
  • Pediatric acute leukemia
  • Unrelated donor

Cite this

Twenty Years of Unrelated Donor Bone Marrow Transplantation for Pediatric Acute Leukemia Facilitated by the National Marrow Donor Program. / MacMillan, Margaret L.; Davies, Stella M.; Nelson, Gene O.; Chitphakdithai, Pintip; Confer, Dennis L.; King, Roberta J.; Kernan, Nancy A.

In: Biology of Blood and Marrow Transplantation, Vol. 14, No. 9 SUPPL., 01.09.2008, p. 16-22.

Research output: Contribution to journalEditorial

MacMillan, Margaret L. ; Davies, Stella M. ; Nelson, Gene O. ; Chitphakdithai, Pintip ; Confer, Dennis L. ; King, Roberta J. ; Kernan, Nancy A. / Twenty Years of Unrelated Donor Bone Marrow Transplantation for Pediatric Acute Leukemia Facilitated by the National Marrow Donor Program. In: Biology of Blood and Marrow Transplantation. 2008 ; Vol. 14, No. 9 SUPPL. pp. 16-22.
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