December 21, 2009
Two important articles have recently been published
- Successful transplantation in adults with sickle cell disease In what may be a major “break-through“ in the care of patients with sickle cell disease, an article in the NEJM reports results using a reduced-intensity conditioning (RIC) regimen for transplantation of adults with sickle cell anemia. This regimen (in contrast to some previously reported RIC regimens for hemoglobinopathies) resulted in 100% overall survival and a reversal of the sickle cell phenotype in 93% of transplanted patients (13 of 14). Although the study is small, the authors commented, “Our patients have had a remarkable change in their lives. They are no longer being admitted to the hospital for frequent pain crises, they have been able to stop chronic pain medications, go back to school and work, get married and have children. Given these results, our regimen will likely have broad application to other nonmalignant diseases and can be performed at most transplant centers.”ptimal management of patients receiving a CB transplant. See Category XII. Section iC. Sickle Cell Disease Bone Marrow and PBSC Transplantation, Citation 1
- The significance of non-inherited maternal antigens (NIMAs) in selection of cord blood units for unrelated donor transplantation. The authors explored the question as to whether in utero exposure to NIMAs, as a result of two-way traffic of cells and molecules such as soluble HLA antigens between mother and fetus during pregnancy and consequent development of immunity and tolerance, may affect graft responses to recipient HLA. The authors demonstrated that transplantation of units with a NIMA match improved survival, and indicated that matching for donor NIMAs in search algorithms of CB inventories, the probability of selecting a graft with an optimal outcome will increase very significantly. See Category V. Donor Selection for Unrelated Cord Blood Transplantation. Citation 1
