Analysis of 462 transplantations from unrelated donors facilitated by the national marrow donor program

Nancy A. Kernan, Glenn Bartsch, Robert C. Ash, Patrick G. Beatty, Richard Champlin, Alexandra Filipovich, James Gajewski, John A. Hansen, Jean Henslee-Downey, Jeffrey Mccullough, Philip Mcglave, Herbert A. Perkins, Gordon L. Phillips, Jean Sanders, David Stroncek, E. Donnall Thomas, Karl G. Blume

Research output: Contribution to journalArticle

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Abstract

Background and Methods. Allogeneic bone marrow transplantation is curative in a substantial number of patients with hematologic cancers, marrow-failure disorders, immunodeficiency syndromes, and certain metabolic diseases. Unfortunately, only 25 to 30 percent of potential recipients have HLA-identical siblings who can act as donors. In 1986 the National Marrow Donor Program was created in the United States to facilitate the finding and procurement of suitable marrow from unrelated donors for patients lacking related donors. Results. During the first four years of the program, 462 patients with acquired and congenital lymphohematopoietic disorders or metabolic diseases received marrow transplants from unrelated donors. The probability of engraftment by 100 days after transplantation was 94 percent, although 8 percent of patients later had secondary graft failure. The probability of grade II, III, or IV acute graft-versus-host disease was 64 percent, and the probability of chronic graft-versus-host disease at one year was 55 percent. The rate of disease-free survival at two years among patients with leukemia and good prognostic factors was 40 percent and among patients at higher risk, 19 percent. Twenty-nine percent of the patients with aplastic anemia were alive at two years, and the rate of two-year disease-free survival among patients with myelodysplasia was 18 percent. For patients with congenital immunologic or nonimmunologic disorders, the probability of survival was 52 percent. Conclusions. The National Marrow Donor Program has benefited a substantial number of patients in need of marrow transplants from closely HLA-matched unrelated donors and has facilitated the recruitment of unrelated donors into the donor pool and the access to suitable marrow.

Original languageEnglish (US)
Pages (from-to)593-602
Number of pages10
JournalNew England Journal of Medicine
Volume328
Issue number9
StatePublished - Mar 4 1993
Externally publishedYes

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Unrelated Donors
Transplantation
Bone Marrow
Tissue Donors
Metabolic Diseases
Graft vs Host Disease
Transplants
Disease-Free Survival
Congenital, Hereditary, and Neonatal Diseases and Abnormalities
Aplastic Anemia
Homologous Transplantation
Bone Marrow Transplantation
Siblings
Leukemia

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Kernan, N. A., Bartsch, G., Ash, R. C., Beatty, P. G., Champlin, R., Filipovich, A., ... Blume, K. G. (1993). Analysis of 462 transplantations from unrelated donors facilitated by the national marrow donor program. New England Journal of Medicine, 328(9), 593-602.

Analysis of 462 transplantations from unrelated donors facilitated by the national marrow donor program. / Kernan, Nancy A.; Bartsch, Glenn; Ash, Robert C.; Beatty, Patrick G.; Champlin, Richard; Filipovich, Alexandra; Gajewski, James; Hansen, John A.; Henslee-Downey, Jean; Mccullough, Jeffrey; Mcglave, Philip; Perkins, Herbert A.; Phillips, Gordon L.; Sanders, Jean; Stroncek, David; Thomas, E. Donnall; Blume, Karl G.

In: New England Journal of Medicine, Vol. 328, No. 9, 04.03.1993, p. 593-602.

Research output: Contribution to journalArticle

Kernan, NA, Bartsch, G, Ash, RC, Beatty, PG, Champlin, R, Filipovich, A, Gajewski, J, Hansen, JA, Henslee-Downey, J, Mccullough, J, Mcglave, P, Perkins, HA, Phillips, GL, Sanders, J, Stroncek, D, Thomas, ED & Blume, KG 1993, 'Analysis of 462 transplantations from unrelated donors facilitated by the national marrow donor program', New England Journal of Medicine, vol. 328, no. 9, pp. 593-602.
Kernan NA, Bartsch G, Ash RC, Beatty PG, Champlin R, Filipovich A et al. Analysis of 462 transplantations from unrelated donors facilitated by the national marrow donor program. New England Journal of Medicine. 1993 Mar 4;328(9):593-602.
Kernan, Nancy A. ; Bartsch, Glenn ; Ash, Robert C. ; Beatty, Patrick G. ; Champlin, Richard ; Filipovich, Alexandra ; Gajewski, James ; Hansen, John A. ; Henslee-Downey, Jean ; Mccullough, Jeffrey ; Mcglave, Philip ; Perkins, Herbert A. ; Phillips, Gordon L. ; Sanders, Jean ; Stroncek, David ; Thomas, E. Donnall ; Blume, Karl G. / Analysis of 462 transplantations from unrelated donors facilitated by the national marrow donor program. In: New England Journal of Medicine. 1993 ; Vol. 328, No. 9. pp. 593-602.
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abstract = "Background and Methods. Allogeneic bone marrow transplantation is curative in a substantial number of patients with hematologic cancers, marrow-failure disorders, immunodeficiency syndromes, and certain metabolic diseases. Unfortunately, only 25 to 30 percent of potential recipients have HLA-identical siblings who can act as donors. In 1986 the National Marrow Donor Program was created in the United States to facilitate the finding and procurement of suitable marrow from unrelated donors for patients lacking related donors. Results. During the first four years of the program, 462 patients with acquired and congenital lymphohematopoietic disorders or metabolic diseases received marrow transplants from unrelated donors. The probability of engraftment by 100 days after transplantation was 94 percent, although 8 percent of patients later had secondary graft failure. The probability of grade II, III, or IV acute graft-versus-host disease was 64 percent, and the probability of chronic graft-versus-host disease at one year was 55 percent. The rate of disease-free survival at two years among patients with leukemia and good prognostic factors was 40 percent and among patients at higher risk, 19 percent. Twenty-nine percent of the patients with aplastic anemia were alive at two years, and the rate of two-year disease-free survival among patients with myelodysplasia was 18 percent. For patients with congenital immunologic or nonimmunologic disorders, the probability of survival was 52 percent. Conclusions. The National Marrow Donor Program has benefited a substantial number of patients in need of marrow transplants from closely HLA-matched unrelated donors and has facilitated the recruitment of unrelated donors into the donor pool and the access to suitable marrow.",
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AU - Beatty, Patrick G.

AU - Champlin, Richard

AU - Filipovich, Alexandra

AU - Gajewski, James

AU - Hansen, John A.

AU - Henslee-Downey, Jean

AU - Mccullough, Jeffrey

AU - Mcglave, Philip

AU - Perkins, Herbert A.

AU - Phillips, Gordon L.

AU - Sanders, Jean

AU - Stroncek, David

AU - Thomas, E. Donnall

AU - Blume, Karl G.

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N2 - Background and Methods. Allogeneic bone marrow transplantation is curative in a substantial number of patients with hematologic cancers, marrow-failure disorders, immunodeficiency syndromes, and certain metabolic diseases. Unfortunately, only 25 to 30 percent of potential recipients have HLA-identical siblings who can act as donors. In 1986 the National Marrow Donor Program was created in the United States to facilitate the finding and procurement of suitable marrow from unrelated donors for patients lacking related donors. Results. During the first four years of the program, 462 patients with acquired and congenital lymphohematopoietic disorders or metabolic diseases received marrow transplants from unrelated donors. The probability of engraftment by 100 days after transplantation was 94 percent, although 8 percent of patients later had secondary graft failure. The probability of grade II, III, or IV acute graft-versus-host disease was 64 percent, and the probability of chronic graft-versus-host disease at one year was 55 percent. The rate of disease-free survival at two years among patients with leukemia and good prognostic factors was 40 percent and among patients at higher risk, 19 percent. Twenty-nine percent of the patients with aplastic anemia were alive at two years, and the rate of two-year disease-free survival among patients with myelodysplasia was 18 percent. For patients with congenital immunologic or nonimmunologic disorders, the probability of survival was 52 percent. Conclusions. The National Marrow Donor Program has benefited a substantial number of patients in need of marrow transplants from closely HLA-matched unrelated donors and has facilitated the recruitment of unrelated donors into the donor pool and the access to suitable marrow.

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