Skip to main content

Advertisement

SpringerLink
Log in

Outcomes Following Allogeneic Stem Cell Transplantation Using Non-sibling Family Donors

  • Original Article
  • Published:
Indian Journal of Hematology and Blood Transfusion Aims and scope Submit manuscript

Abstract

For patients requiring allogeneic stem cell transplant, in the absence of a HLA-matched sibling, an extended donor search within the family may yield a suitable donor especially in societies with a high prevalence of consanguinity. We describe outcomes in transplants with non-sibling family donors, and compare outcomes with controls having a sibling donor transplant. Retrospective analysis of all matched related (non-sibling) donor transplants between 1995 and 2015. For comparison, appropriate age, sex and disease-matched patients were chosen from the sibling transplants (MSD) performed during the same time period (± 2 years). Comparison between the fully matched non-sibling donor cohort and age, sex and disease-matched sibling donor transplants showed a significant increase in complications in the family donor group (viral infections, acute GVHD and rejection). Event-free survival and overall survival were significantly lower in the non-sibling donor cohort, and HLA disparity (1–2 antigen) further worsened the adverse impact. Though there was a significantly lower event-free and overall survival at 3 years in the family donor cohort, this did not retain significance in the multivariate analysis. This data on allogeneic transplants using family donors showed higher complication rates and poorer outcomes. However in situations where financial constraints prevent access to matched unrelated donor sources, extended family searches may be fruitful in yielding a donor, and modifications in conditioning regimens and improvement in supportive care may help in improving the outcomes in family donor transplants.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. DiLabio J, Doyle J, Alexander S, Gupta S, Punnett A (2015) Impact of ethnicity on donor search results for children requiring stem cell transplantation. J Pediatr Hematol Oncol 37(3):e154–e157

    Article  PubMed  Google Scholar 

  2. Gragert L, Eapen M, Williams E, Freeman J, Spellman S, Baitty R et al (2014) HLA match likelihoods for hematopoietic stem-cell grafts in the U.S. registry. N Engl J Med 371(4):339–348

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Pidala J, Kim J, Schell M, Lee SJ, Hillgruber R, Nye V et al (2013) Race/ethnicity affects the probability of finding an HLA-A, -B, -C and -DRB1 allele-matched unrelated donor and likelihood of subsequent transplant utilization. Bone Marrow Transpl 48(3):346–350

    Article  CAS  Google Scholar 

  4. Patil R (2012) First cousin marriages: genetic concerns versus value judgement. Natl Med J India 25(3):187

    PubMed  Google Scholar 

  5. Saadat M, Ansari-Lari M, Farhud DD (2004) Consanguineous marriage in Iran. Ann Hum Biol 31:263

    Article  CAS  PubMed  Google Scholar 

  6. Hussein AA, Al-Zaben A, Khattab E, Haroun A, Frangoul H (2016) Hematopoietic stem cell transplantation from non-sibling matched family donors for patients with thalassemia major in Jordan. Pediatr Transpl 20(1):120–123

    Article  Google Scholar 

  7. de Medeiros CR, Bitencourt MA, Zanis-Neto J, Maluf EC, Carvalho DS, Bonfim CS et al (2006) Allogeneic hematopoietic stem cell transplantation from an alternative stem cell source in Fanconi anemia patients: analysis of 47 patients from a single institution. Braz J Med Biol Res 39(10):1297–1304

    Article  PubMed  Google Scholar 

  8. Guardiola P, Socié G, Pasquini R, Dokal I, Ortega JJ, van Weel-Sipman M et al (1998) Allogeneic stem cell transplantation for Fanconi Anaemia. Severe Aplastic Anaemia Working Party of the EBMT and EUFAR. European Group for Blood and Marrow Transplantation. Bone Marrow Transpl 21(Suppl 2):S24–S27

    Google Scholar 

  9. Gaziev D, Galimberti M, Lucarelli G, Polchi P, Giardini C, Angelucci E et al (2000) Bone marrow transplantation from alternative donors for thalassemia: HLA-phenotypically identical relative and HLA-nonidentical sibling or parent transplants. Bone Marrow Transpl 25(8):815–821

    Article  CAS  Google Scholar 

  10. Harris RE (2003) Fanconi anemia: matched sibling donor haematopoietic cell transplantation. In: Joyce Owen J, Frohnmayer L, Eiler ME (eds) Fanconi anemia: standards for clinical care. Fanconi Anemia Research Fund, Eugene, pp 95–106

    Google Scholar 

  11. Balci YI, Tavil B, Tan CS, Ozgur TT, Bulum B, Cetin M et al (2011) Increased availability of family donors for hematopoietic stem cell transplantation in a population with increased incidence of consanguinity. Clin Transpl 25(3):475–480

    Article  Google Scholar 

  12. Kanda Y, Chiba S, Hirai H, Sakamaki H, Iseki T, Kodear Y et al (2003) Allogeneic hematopoietic stem cell transplantation from family members other than HLA-identical siblings over the last decade (1991–2000). Blood 102(4):1541–1547

    Article  CAS  PubMed  Google Scholar 

  13. Hamidieh AA, Dehaghi MO, Paragomi P, Navaei S, Jalali A et al (2015) Efficiency of allogeneic hematopoietic SCT from HLA fully-matched non-sibling relatives: a new prospect of exploiting extended family search. Bone Marrow Transpl 50(4):545–552

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Haematology, Christian Medical College and Hospital, Vellore, 632004, India

    Anu Korula, Anup J. Devasia, N. A. Fouzia, P. N. Nisham, Uday Kulkarni, Kavitha M. Lakshmi, Aby Abraham, Alok Srivastava, Vikram Mathews & Biju George

Authors
  1. Anu Korula
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anup J. Devasia
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. N. A. Fouzia
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P. N. Nisham
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Uday Kulkarni
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kavitha M. Lakshmi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Aby Abraham
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Alok Srivastava
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Vikram Mathews
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Biju George
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Biju George.

Ethics declarations

Conflict of interest

This study was not funded and there are no conflicts of interest to disclose.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Korula, A., Devasia, A.J., Fouzia, N.A. et al. Outcomes Following Allogeneic Stem Cell Transplantation Using Non-sibling Family Donors. Indian J Hematol Blood Transfus 35, 43–49 (2019). https://doi.org/10.1007/s12288-018-0988-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12288-018-0988-z

Keywords

Search

Navigation