[Comparative study of bone marrow transplantation from unrelated donors and identical sibling donors in a single...

This retrospective study analyzes the result of bone marrow transplantation in 28 patients with unrelated donors compared with 75 patients transplanted from identical HLA sibling donors at a single institute during the same time period. One unrelated donor patient with severe aplastic anemia died without evidence of engraftment. The incidence of grade III-IV acute graft-versus-host disease (GVHD) in unrelated donor patients (19%) was higher than sibling donors (0%) and the probability of survival more than 30 years was lower compared with sibling donors. However, the probability of survival without grade III-IV acute GVHD was similar in the two groups, 62% (n = 21) vs. 65% (n = 75), and there was no significant difference in relapse-free survival, good prognostic factors; 76% (n = 11) vs. 66% (n = 37), higher risk factors; 30% (n = 11) vs. 31% (n = 21). Death due to viral infection were significantly higher among unrelated donor patients. We conclude that bone marrow transplantation for patients younger than 30 years old from unrelated donors should be considered equally to sibling donors with great care to engraftment for severe aplastic anemia, grade III-IV acute GVHD and viral infection.