Outcomes Following Allogeneic Stem Cell Transplantation Using Non-sibling Family Donors
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For patients requiring allogeneic stem cell transplant, in the absence of a HLA-matched sibling, an extended donor search within the family may yield a suitable donor especially in societies with a high prevalence of consanguinity. We describe outcomes in transplants with non-sibling family donors, and compare outcomes with controls having a sibling donor transplant. Retrospective analysis of all matched related (non-sibling) donor transplants between 1995 and 2015. For comparison, appropriate age, sex and disease-matched patients were chosen from the sibling transplants (MSD) performed during the same time period (± 2 years). Comparison between the fully matched non-sibling donor cohort and age, sex and disease-matched sibling donor transplants showed a significant increase in complications in the family donor group (viral infections, acute GVHD and rejection). Event-free survival and overall survival were significantly lower in the non-sibling donor cohort, and HLA disparity (1–2 antigen) further worsened the adverse impact. Though there was a significantly lower event-free and overall survival at 3 years in the family donor cohort, this did not retain significance in the multivariate analysis. This data on allogeneic transplants using family donors showed higher complication rates and poorer outcomes. However in situations where financial constraints prevent access to matched unrelated donor sources, extended family searches may be fruitful in yielding a donor, and modifications in conditioning regimens and improvement in supportive care may help in improving the outcomes in family donor transplants.
KeywordsFamily donor Allogeneic Transplant Non-sibling Outcome
Compliance with Ethical Standards
Conflict of interest
This study was not funded and there are no conflicts of interest to disclose.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
- 4.Patil R (2012) First cousin marriages: genetic concerns versus value judgement. Natl Med J India 25(3):187Google Scholar
- 7.de Medeiros CR, Bitencourt MA, Zanis-Neto J, Maluf EC, Carvalho DS, Bonfim CS et al (2006) Allogeneic hematopoietic stem cell transplantation from an alternative stem cell source in Fanconi anemia patients: analysis of 47 patients from a single institution. Braz J Med Biol Res 39(10):1297–1304CrossRefGoogle Scholar
- 8.Guardiola P, Socié G, Pasquini R, Dokal I, Ortega JJ, van Weel-Sipman M et al (1998) Allogeneic stem cell transplantation for Fanconi Anaemia. Severe Aplastic Anaemia Working Party of the EBMT and EUFAR. European Group for Blood and Marrow Transplantation. Bone Marrow Transpl 21(Suppl 2):S24–S27Google Scholar
- 10.Harris RE (2003) Fanconi anemia: matched sibling donor haematopoietic cell transplantation. In: Joyce Owen J, Frohnmayer L, Eiler ME (eds) Fanconi anemia: standards for clinical care. Fanconi Anemia Research Fund, Eugene, pp 95–106Google Scholar