Trasplantation Stem Cells Scholarly Peer-review Journal

The first successful bone marrow transplantation in humans was performed between identical twins. With a greater understanding of the HLA system, it became possible to perform bone marrow transplantations between siblings who were HLA identical. Transplantation is widely used to treat congenital bone marrow disorders and malignant hematologic diseases. Today, more than 350 centers in Europe are performing over 18,000 transplantations a year. Centers may report their transplantations to the European Bone Marrow Transplant Registry, which periodically publishes outcome data. The European Bone Marrow Transplant Group is establishing a system of voluntary accreditation for transplantation centers, and most centers are likely to seek early accreditation. Transplants from unrelated volunteers are associated with higher morbidity and mortality than those from matched siblings, but outcomes are improving,2 partly because modern molecular techniques allow closer matching of donors and recipients. Patients with chronic myeloid leukemia who are considered a good risk for transplantation (aged 20-40 years, seronegative for cytomegalovirus, in chronic phase, and receive a transplant within 1 year of diagnosis from a closely matched donor) have outcomes approaching those seen in allogeneic transplantations between siblings—that is, more than 70% survival at 5 years. Patients with common HLA types have a good chance of getting a match, unlike those with rarer HLA types, such as patients from ethnic minorities or those of mixed parentage.