Bone Marrow Transplantation in Thalassemia (Part 2)
During the last two decades conventional therapy has improvedthe prognosis of thalassemia. However, despite such improvementit still remains a progressive disease with treatment-relatedcomplications such as hepatitis, liver fibrosis, and cardiac disease.Bone marrow transplantation (BMT) can prevent...
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| Format: | Article |
| Language: | English |
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Shiraz University of Medical Sciences
2009-06-01
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| Series: | Iranian Journal of Medical Sciences |
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| Online Access: | http://ijms.sums.ac.ir/files/PDFfiles/34_2_01-Dr_%20Zakerinia.pdf |
| Summary: | During the last two decades conventional therapy has improvedthe prognosis of thalassemia. However, despite such improvementit still remains a progressive disease with treatment-relatedcomplications such as hepatitis, liver fibrosis, and cardiac disease.Bone marrow transplantation (BMT) can prevent or delayprogression of the aforementioned complications. The importanceof clinical research in the field of BMT was recognizedwith the award of the 1990 Nobel Prize in Physiology andMedicine to E. Donnall Thomas, one of the pioneers of BMT inhumans. George Mathe' was a pioneer in the early developmentof clinical BMT. Mathe' and co-workers were the first to describegraft-versus-host-disease and its treatment, and the graftversus-leukemia effect in human. The first BMT for β-thalassemia major was performed successfully by Thomas andcolleagues in Seattle, in 1981. In the same year another patientwith β-thalassemia major underwent BMT in Pesaro, Italy, byLucarelli and others Since then, several hundred transplantationshave been performed worldwide, mostly in Italy. From 1991through 2007 BMT have been performed on 497 (Tehran=342,Shiraz=155) blood transfusion dependent patients with thalassemiamajor in Iran, with disease-free survival of 71-77% respectively.Because of high graft failure and high rates of graftversus-host-disease rates, BMT from alternative donors shouldbe restricted to patients who have poor life expectancies becausethey cannot receive adequate conventional treatment or becauseof alloimmunization to minor blood antigens. Beginning in theearly 1980s, it was shown that umbilical cord blood containedhigh levels of hematopoietic progenitor cells. |
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| ISSN: | 0253-0716 1735-3688 |