Increasing success rates of half-matched bone-marrow transplantations

Bone-marrow transplantation is often the only treatment for children with non-cancerous blood and immune disorders. 

Ideally, donors should have a human leukocyte antigen (HLA), a marker used by the immune system to recognize foreign cells, which matches that of the patient for better outcomes. However, since it is not always possible to find a compatible donor, a procedure known as half-matched (haploidentical) bone-marrow transplantation can be used to make more patients eligible for bone-marrow transplantation.

A team of researchers, led by Alice Bertaina from the Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Pediatrico Bambino Gesu Childrens Hospital in Rome, and including Nabil Kabarra from the Rafic Hariri University Hospital in Beirut, gave 23 children with nonmalignant disorders half-matched bone-marrow transplantations, publishing their findings in Blood¹. 

In an attempt to overcome the increased risks associated with this type of transplantation, including delayed recovery of adaptive immunity and transplantation-related mortality, the team selectively eliminated the αβ-positive T cells and CD19-positive B cells from the donor graft.

The transplantations proved to be successful in all but two of the patients. The two-year probability of disease-free survival was 91.1%, suggesting that the method is a safe and effective way to expand the donor pool for children who do not have HLA matched donors.

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