Alternative donor transplants for severe aplastic anemia: current experience
Andrea Bacigalupo1, Simona Sica1
1Department of Hematology, Universita' Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Gemelli Roma, Largo Agostino Gemelli 1, Rome, Italy.
Seminars in Hematology
|March 23, 2016
Summary
For severe aplastic anemia (SAA) patients without a matched sibling, alternative donor transplants offer improved outcomes. Unrelated donor transplants show significant progress, while haploidentical grafts are promising but experimental.
Area of Science:
- Hematology
- Immunology
- Transplantation Medicine
Background:
- Acquired severe aplastic anemia (SAA) patients lacking an HLA-identical sibling donor face limited therapeutic choices.
- Current European Group for Blood and Marrow Transplantation (EBMT) guidelines recommend immunosuppressive therapy (IST) with anti-thymocyte globulin (ATG) and cyclosporine (CsA) first, followed by transplantation if IST fails.
Purpose of the Study:
- To review recent outcomes of alternative donor stem cell transplantation for SAA patients.
- To evaluate transplants from matched unrelated donors (UD), cord blood (CB), and human leukocyte antigen (HLA)-haploidentical (HAPLO) donors.
Main Methods:
- Review of recent clinical results and outcomes for SAA patients undergoing alternative donor stem cell transplantation.
- Analysis of data concerning matched UD, CB, and HAPLO grafts.
Main Results:
- Transplants from matched UD and sibling (SIB) donors demonstrate significantly improved outcomes, particularly UD transplants over the last decade.
- Cord blood (CB) transplants are discussed, highlighting challenges related to limited stem cell dose.
- Early results for haploidentical (HAPLO) grafts in patients without other donor options are encouraging, though this approach remains experimental.
Conclusions:
- Alternative donor transplantation, especially from matched unrelated donors, offers a viable and improving therapeutic option for SAA patients.
- Cord blood and haploidentical stem cell transplantation represent developing strategies with specific challenges and potential benefits.
More Related Videos
Related Concept Videos
01:22Bone Marrow Sampling and Transplants
2.3K
Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
2.3K
01:21Stem Cell Therapy for Tissue Regeneration
4.8K
Stem cell therapy is a method used in regenerative medicine to repair and restore function to damaged tissues and organs. Stem cells have the potential to proliferate and differentiate into various tissue types, making them ideal candidates for tissue regeneration. For example, hematopoietic stem cell transplants are commonly used in blood cancer treatment to replenish damaged bone marrow and restore healthy blood cells.
Types of Stem Cells used in Stem Cell Therapy
The two main cell...
Types of Stem Cells used in Stem Cell Therapy
The two main cell...
4.8K
01:17Stem Cell Culture
6.5K
Stem cell research aims to find ways to use stem cells to regenerate and repair cellular damage. Over time, most adult cells undergo the wear and tear of aging and lose their ability to divide and repair themselves. Stem cells do not display a particular morphology or function. Adult stem cells, which exist as a small subset of cells in most tissues, keep dividing and can differentiate into a number of specialized cells generally formed by that tissue. These cells enable the body to renew and...
6.5K
01:24Tissue Transplantation
1.2K
Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
1.2K
01:15Blood Transfusion
2.9K
Blood transfusion is a critical medical procedure that saves lives and treats various medical conditions. It involves transferring blood from a donor to a recipient. This process requires a thorough understanding of the ABO blood group system and its associated antigens and antibodies.
Blood Transfusion Overview
A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...
Blood Transfusion Overview
A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...
2.9K
01:22iPS Cell Differentiation
3.3K
The ability of induced pluripotent stem cells or iPSCs to differentiate into most body cell types has stimulated repair and regenerative medicine research over the past few decades. iPSC-derived blood cells, hepatocytes, beta islet cells, cardiomyocytes, neurons, and other cell types can repair injuries or regenerate damaged tissue in diseases such as diabetes and neurodegenerative disorders.
3.3K