Medicina Fluminensis, Vol. 47 No. 4, 2011.
Izvorni znanstveni članak
Allogeneic stem cell transplantation from matched unrelated donor
Ranka Serventi-Seiwerth
; Zavod za hematologiju, Klinika za unutarnje bolesti, KBC Zagreb, Zagreb, Hrvatska
Mirta Mikulić
; Zavod za hematologiju, Klinika za unutarnje bolesti, KBC Zagreb, Zagreb, Hrvatska
Mirando Mrsić
; Zavod za hematologiju, Klinika za unutarnje bolesti, KBC Zagreb, Zagreb, Hrvatska
Zorana Grubić
; Laboratorij za HLA tipizaciju, KBC Zagreb, Zagreb, Hrvatska
Ines Bojanić
; Zavod za transfuziju, KBC Zagreb, Zagreb
Katarina Štingl
; Laboratorij za HLA tipizaciju, KBC Zagreb, Zagreb, Hrvatska
Boris Labar
; Zavod za hematologiju, Klinika za unutarnje bolesti, KBC Zagreb, Zagreb, Hrvatska
Sažetak
Aim: Stem cell transplantation from HLA-matched unrelated donor (MUD) is a standard therapy similar to allografting from related donor. Here we present the treatment outcome of MUD transplantation in the University Hospital Center Zagreb. Methods: From 1991 to 2010 at the Department of Hematology, University Hospital Center Zagreb 71 patients (average of 28 years, range 1 month to 61 year) underwent MUD transplantation; the reason for transplantation was acute leukemia (34 patients), chronic myeloid leukemia (16 patients), chronic lymphocytic leukemia (4 patients) lymphoma and myeloma (8 patients) and severe aplastic anemia or other disorders (8 patients). According to HLA, the donors were compatible in 6 out of 6 antigens (with low resolution) or in 8 out of 8 antigens, and 8 out of 10, 9 out of 10 and 10 out ten 10 antigens (with high resolution). For conditioning, patients received either standard myeloablative regimen (total body irradiation with cyclophosphamide or busulfan and cyclophosphamide) or fludarabine based reduced intensity regimen. Results: The probability of overall survival was 24 %. The plateau was reached after follow-up of 18 month. Trend for better treatment outcome and survival of 37 % was documented for patients months received stem cells from donors compatible in 10 out of 10 antigens. The principal causes of death after allografting were infections, GvHD, relaps and multiorgan failure. Discussion and conclusion: MUD-transplantation especially with the donor compatible in 10 out of 10 antigens performed in early phase of disease is currently the standard treatment for many malignant hematopoietic tumors and severe aplastic anemia.
Ključne riječi
allogeneic transplatation; high resolution HLA typing; HLA matched unrelated donor stem cells transplantation; reduced intensity conditioning; standard myeloablative conditioning regimen
Hrčak ID:
76671
URI
Datum izdavanja:
1.12.2011.
Posjeta: 5.230 *