Effect of HLA compatibility on engraftment of bone marrow transplants in patients with leukemia or lymphoma

Article Abstract:

In the treatment of diseases such as leukemia and lymphoma, patients requiring bone marrow transplants are likely to have fewer post-transplant complications if the bone marrow donors are siblings who have identical human blood leukocyte antigen (HLA) complexes (specific inherited blood types). This blood compatibility generally prevents the rejection of donated bone marrow. Graft versus host disease (GVHD) occurs when the immune system of the host recognizes the donated tissue as foreign and tries to fight it off through a process of rejection. Some leukemia and lymphoma patients who require bone marrow transplant do not have a sibling with identical HLA complexes. To determine whether the tissue of relatives with partially similar HLA complexes could be used successfully, 269 patients received bone marrow transplants from donor relatives with whom they shared one HLA antigen. These results were compared to the transplant outcomes of 930 patients who received tissue from siblings having identical HLA complexes. The graft failure rate was 12.3 percent in patients who were given bone marrow tissue from non-identical HLA complex relatives, compared to a 2.0 percent failure rate in patients who had identical HLA complex sibling donors. The more incompatible the donor the higher the graft failure rate. Methods of reducing the immune response in patients who must receive tissue transplants from relatives with whom they do not share identical HLA complexes requires further research.

Research, HLA histocompatibility antigens, HLA antigens, Lymphomas, Graft versus host reaction, Graft vs. host disease

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Bone marrow transplantation for patients with myelodysplasia

Article Abstract:

Myelodysplastic syndrome includes a variety of blood cell disorders caused by impaired cell maturation. The lack of mature blood cells can lead to many potentially fatal complications. Various types of therapies have been used to treat patients with myelodysplastic syndrome, but with little success. However, several cases have suggested that myelodysplastic syndrome may be treated with bone marrow transplantation. To examine the use of bone marrow transplantation for the treatment of myelodysplastic syndrome, 59 patients with myelodysplasia, or closely related disorders, were given bone marrow transplants and followed-up for one year. The estimate of disease-free survival for three years was 45 percent. The most common causes of death after transplantation included recurrent myelodysplasia, pneumonia, and graft-versus-host disease. Statistical analysis showed that younger patients who had the disease for shorter periods of time, or those who had chromosomal abnormalities had greater chances of disease-free survival and long-term survival. Patients who had fewer blasts, or immature cells, in their bone marrow when they received the transplant had a decreased chance for disease recurrence, compared with patients who had greater numbers of blasts. Therefore, bone marrow transplantation may provide a cure for patients with myelodysplasia, especially younger patients who have recently developed the disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Bone marrow cells, Transplantation of organs, tissues, etc., Organ transplantation, Tissue transplantation, Transplantation, Myelodysplastic syndromes

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Transplantation of bone marrow as compared with peripheral-blood cells from HLA-identical relatives in patients with hematologic cancers

Article Abstract:

Hematologic stem cells can restore the immune system faster than bone marrow transplants in patients with blood cancer whose immune system is damaged by chemotherapy and radiation. Hematologic stem cells are the precursor of all blood cells. They can be produced in large numbers quickly by a donor who takes a drug that stimulates their production.

Hematopoietic stem cells, Hematopoietic stem cell transplantation

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