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Choosing a donor for SCT

Choosing a donor for SCT. Paul Veys Director Blood and Marrow Transplantation GOSH Honorary Clinical Professor UCL. Sibling donor. No Transplant. Unrelated cord blood. Mismatched family donor “Haploidentical”. Volunteer unrelated donor. Creation of “saviour sibling” Gene therapy.

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Choosing a donor for SCT

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  1. Choosing a donor for SCT Paul Veys Director Blood and Marrow Transplantation GOSH Honorary Clinical Professor UCL

  2. Sibling donor No Transplant Unrelated cord blood Mismatched family donor “Haploidentical” Volunteer unrelated donor Creation of “saviour sibling” Gene therapy

  3. Allogeneic transplants in patients £20 years,by donor type and graft source, registered with CIBMTR, 1991-2008 5,000 Related, BM or PB Unrelated, BM or PB Unrelated, CB 4,500 4,000 3,500 3,000 Number of Transplants Number of Transplants 2,500 2,000 1,500 1,000 500 0 * * Data incomplete 1991-92 1993-94 1995-96 1997-98 1999-00 2001-02 2003-04 2005-06 2007-08 Slide 12 SUM10_14.ppt

  4. Outcomes by year: sibling vs unrelatedOne-year survival after myeloablative conditioning for acute leukemias in any remission phase, CML or MDS, age <50 years, by year of transplant and graft source, 1988-2008 100 Sibling Donor Unrelated Donor 80 60 One-Year Survival, % 40 20 0 1988-90 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Slide 16 SUM10_18.ppt

  5. Volunteer Donor RegistriesEthnic minorities – London CBB

  6. NMDP Transplants by Cell Source 6

  7. NMDP Transplants for Minority Patients by Cell Source 7

  8. GOSH unrelated donors: adult vs cord

  9. Potential advantages and disadvantages of different types of stem cell donor British Journal of Haematology 2003; 123: 193-206 Bone Marrow Transplantation 2006; 37: 90-908 British Journal of Haematology 2009; Aug 25.

  10. Donor hierarchy: paediatric leukaemia

  11. Donor hierarchy: immunodeficiency/metabolic disease

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