Outcome of Pediatric Hematopoietic Stem Cell Transplantations from Thai Unrelated Donors Matched with High-Resolution HLA Typing
Preeda Vanichsetakul MD*, Rachanee O-Charoen MD**, Panya Seksarn MD*, Pawinee Kupatawintu BSc**
Affiliation : * Department of Pediatrics, Faculty of Medicine, Chulalongkorn University ** National Blood Centre, Thai Red Cross Society
The authors evaluated the outcome of ten children given hematopoietic stem cell transplantations from Thai unrelated donors (URD-HSCT) selected using DNA high-resolution typing of both HLA class I and II loci. Six patient/donor pairs (60%) were fully matched; four (40%) were 5/6 matched. Patients had either non-malignant (n=9) or malignant (n=1) diseases. In most cases, graft-versus-host disease (GVHD) prophy- laxis composed of cyclosporine and short-term methotrexate. The probability of hematopoietic recovery at day 30 was 90%. The cumulative probability of acute GVHD and of chronic GVHD equaled 44.4 and 0%, respectively. Three patients died of transplant-related complications. The probability of transplant-related mortality (TRM) at 30, 100, and 180 days were 10, 30, and 30%, respectively. The overall and disease-free survival rates were 70 and 70%, respectively. URD-HSCT with donor selection based on high-resolution HLA typing is associated with a low incidence of both severe acute GVHD and graft failure. The observed outcome is comparable to that of children transplanted from HLA-identical siblings.
Keywords : Unrelated donor, Stem cell transplantation, HLA, Acute GVHD, Graft failure
