Unrelated donor marrow transplantation: An update of the experience of the Italian Bone Marrow Transplant Group (GITMO)

Giorgio Dini, Roberta Cancedda, Franco Locatelli, Alberto Bosi, Giuseppe Bandini, E. Paolo Alessandrino, Fulvio Porta, Cornelio Uderzo, Chiara Messina, Franca Fagioli, William Arcese, Paola Marenco, Renato Fanin, Michele Falda, Davide Soligo, Giorgio La Nasa, Claudio Giardini, Andrea Pession, Rosanna Scimè, Paolo Di BartolomeoBarbara Bruno, Lucia Garbarino, Teresa Lamparelli, Giovanna Giorgiani, Edoardo Lanino, Carla Manzitti, Andrea Bacigalupo

Research output: Contribution to journalArticle

Abstract

Background and Objectives. Unrelated donor bone marrow transplant (UD BMT) has become an attractive alternative source of hematopoietic cells for patients lacking a matched sibling. The aim of this paper was to report on results of the 696 UD BMTs performed in 31 Italian institutions during the first 10 years of activity of the Italian Bone Marrow Donor Registry (IBMDR). Evidence and Information Sources. In 1989 the Italian Bone Marrow Transplant Group (GITMO) established the IBMDR to facilitate donor search and marrow procurement for patients lacking an HLA identical sibling. By the end of December 1999, 260,000 HLA-A, B typed volunteer donors had been cumulatively registered and 2,620 searches had been activated for Italian patients. At least one HLA-A, B, DRB1 matched donor was found for 54% of the patients and 696 UD BMTs were performed. In 50% of cases the donor was found in the IBMDR and in 50% in 15 other Registries. The average time from search activation to transplant was 6 months for disease other than CML For CML it was 14 months. Actuarial 12-month transplant-related mortality (TRM) was 68% in patients grafted between 1979 and 1992 and 44% for patients grafted after 1993. Twenty-eight per cent of patients developed grade III or IV acute GvHD and 24% developed extensive chronic GvHD. The rate of disease free survival at three years was 57% for patients with 1st chronic phase CML, 37% for patients with 1st or 2nd CR ALL, 31% for AML or MDS patients ≤ 18 years of age and 54% for patients with inborn errors. Perspectives. We conclude that the IBMDR has benefited a substantial number of patients lacking a matched sibling and has facilitated the recruitment of UDs into the international donor pool. The long time required for the search is the major obstacle to the success of this program. This suggests that early transplant and a decrease in TRM could further improve these encouraging results.

Original languageEnglish
Pages (from-to)451-456
Number of pages6
JournalHaematologica
Volume86
Issue number5
Publication statusPublished - May 2001

Keywords

  • Bone marrow transplant from unrelated donor (UD BMT)
  • Italian Bone Marrow Donor Registry (IBMDR)
  • Italian Bone Marrow Transplant Group (GITMO)

ASJC Scopus subject areas

  • Hematology

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    Dini, G., Cancedda, R., Locatelli, F., Bosi, A., Bandini, G., Alessandrino, E. P., Porta, F., Uderzo, C., Messina, C., Fagioli, F., Arcese, W., Marenco, P., Fanin, R., Falda, M., Soligo, D., La Nasa, G., Giardini, C., Pession, A., Scimè, R., ... Bacigalupo, A. (2001). Unrelated donor marrow transplantation: An update of the experience of the Italian Bone Marrow Transplant Group (GITMO). Haematologica, 86(5), 451-456.