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Study Summaries

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Study Summaries for Patients

The CIBMTR performs ground-breaking research into blood and marrow transplant. This research has a significant impact on the survival and quality of life of thousands of transplant and cellular therapy patients. Here we provide summaries of CIBMTR research in an easy-to-read way. Now you and your family have access to useful information that can help you talk with your doctor about treatment options.

Study summaries are organized by disease / condition and other transplant characteristics. More easy-to-read information about transplant, including diseases treatable by transplant, is available on the Be The Match website. For help understanding this information, contact the Be The Match Patient Support Center at 1 (888) 999-6743 or patientinfo@nmdp.org.

Diseases and Conditions

Acute Leukemia
Cancer in Children and Teens
Chronic Leukemia and Myelodysplastic Syndromes
Graft-versus-Host Disease
Lymphoma
Multiple Myeloma
Other Diseases

Other Topics related to Transplant

​Access to Transplant
Donor Health and Safety
Donor Selection
HLA Matching and Biologic Factors
Late Effects and Quality of Life
Social and Financial Aspects of Transplant
Trends in Transplant

Diseases and Conditions


Acute Leukemia

Acute leukemia includes acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). AML is the most common type of acute leukemia. Nearly 15,000 new cases are found in the United States each year. AML can affect people of any age, but is most common in adults. There are about 6,000 new cases of ALL in the United States each year. It can affect people of any age, but is the most common type of leukemia in children under 15. 

Summary (PDF)​Important Points​Full Article

Patients with myelodysplastic syndromes or acute myeloid leukemia may benefit from a standard preparative regimen

Patients who got a standard preparative regimen were more likely to be cancer-free a year and a half after transplant than patients who got a reduced-intensity regimen.

​Myeloablative versus reduced-intensity hematopoietic cell transplantation for acute myeloid leukemia and myelodysplastic syndromes

Treatment helps children and teens with acute leukemia thrive after cord blood transplantsThe TCF treatment regimen before cord blood transplant helped young people with acute leukemia live longer.Umbilical cord blood transplantation in children with acute leukemia: Impact of conditioning on transplantation outcomes
Early results suggest people live equally long after half-matched transplants using either peripheral blood or bone marrowScientists followed people for two years after transplants for: Acute leukemias, myelodysplastic syndrome, and lymphomas.Mobilized peripheral blood stem cells versus unstimulated bone marrow as a graft source for T-cell—replete haploidentical donor transplantation using post-transplant cyclophosphamide
​A transplant from an unrelated donor can treat acute lymphoblastic leukemia

New research may make it possible for more people with acute lymphoblastic leukemia (ALL) to get life-saving transplants.

In the past, a transplant using blood-forming cells from a sibling was the only well-tested transplant option.

New research shows that a transplant from an unrelated donor can help people with ALL live equally long as a transplant from a sibling.

Comparing outcomes of matched related donor and matched unrelated donor hematopoietic cell transplants in adults with B-cell acute lymphoblastic leukemia
​Cytogenetics predict transplant results in older patients with acute myeloid leukemiaCytogenetic testing can predict BMT outcomes in older patients with AML.

Transplant works for about 1 of every 3 older patients with AML.

Cytogenetic risk determines outcomes after allogeneic transplantation in older patients with acute myeloid leukemia in their second complete remission: A Center for International Blood and Marrow Transplant Research cohort analysis

Less chronic GVHD after cord blood transplant for acute leukemia

Patients had less chronic GVHD after cord blood transplants.

Patients who received ATG had less acute GVHD.

GVHD after umbilical cord transplantation for acute leukemia: An analysis of risk factors and effect on outcomes

Blood or marrow transplant can work well to treat B-cell acute lymphoblastic leukemia for older patients

​Reduced-intensity BMT can work well for older patients with B-cell ALL.

For patients who had BMT when the disease was in the 1st complete remission, almost half (45%) were alive 3 years later.

​​Reduced intensity conditioned allograft yields favorable survival for older adults with B-Cell acute lymphoblastic leukemia: A CIBMTR analysis

Transplant may help older patients with acute myeloid leukemia​Reduced-intensity transplant is a good treatment option for some older patients with AML.

Phase II study of allogeneic transplantation for older patients with acute myeloid leukemia in first complete remission using a reduced-intensity conditioning regimen: Results from Cancer and Leukemia Group B 100103 (Alliance for Clinical Trials in Oncology)/Blood and Marrow Transplant Clinical Trial Network 0502

​More teens and young adults with ALL survive after blood or marrow transplant than in the past

​5-year survival increased over time in teens and young adults and in children.

Survival improvements in adolescents and young adults after myeloblative allogeneic transplantation for acute lymphoblastic leukemia

Allo transplant helps some older patients with AML

​Older patients (aged 65 years and older) with AML can get high dose chemo if they are healthy enough.

About half of the older patients who get high dose chemo go into remission. However, the disease usually comes back within a year.

About 40% of older patients in remission who get an allo transplant live at least 2 years.

It is important for patients to talk with their doctor about an allo transplant as soon as they find out they have AML.

To transplant or not: A dilemma for treatment of elderly AML patients in the twenty-first century

​Similar survival for leukemia patients receiving transplants from related vs. unrelated donors​Patients with leukemia who get a transplant from a well matched unrelated donor or from an unrelated donor with a single mismatch should have similar survival to patients who have a related donor.Outcomes after matched unrelated donor versus identical sibling hematopoietic cell transplantation in adults with acute myelogenous leukemia
​Cytogenetics classifications for leukemia patients undergoing transplantation

​Cytogenetics, or the study of chromosomes, help predict the health of patients with acute myelogenous leukemia (AML).

New risk classifications could be used to predict how well patients with AML will respond to transplant.

​Classifying cytogenetics in patients with acute myelogenous leukemia in complete remission undergoing allogeneic transplantation: A Center for International Blood and Marrow Transplant Research study
Unrelated umbilical cord blood transplants equal to unrelated bone marrow in helping children with acute leukemia​​Children with acute leukemia who receive unrelated umbilical-cord blood transplants have outcomes equal to - or in some cases, better than - those treated with bone marrow. ​Outcomes of transplantation of unrelated donor umbilical cord blood and bone marrow in children with acute leukaemia: A comparison study


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Cancer in Children and Teens

The types of cancers that affect children and teens are often different than the types that affect adults. Children and teens also respond to treatments differently than adults. Some cancers that affect children include leukemia, neuroblastoma, Wilms tumor, and lymphoma.

Summary (PDF)​Important Points​Full Article

Treatment helps children and teens with acute leukemia thrive after cord blood transplants

​The TCF treatment regimen before cord blood transplant helped young people with acute leukemia live longer.

Umbilical cord blood transplantation in children with acute leukemia: Impact of conditioning on transplantation outcomes

Common late effects after transplant in very young children

​30% of very young BMT recipients have organ damage or other late effects.

Common late effects are delayed growth, cataracts, and hypothyroidism.

Full-body radiation increases the chance of getting these late effects.

Survival and late effects after allogeneic hematopoietic cell transplantation for hematologic malignancy at less than three years of age

Some children who donate cells to a brother or a sister have a lower quality of life and need extra support

​About 20% of donors (1 in 5) at each time point had very poor QOL.

Parents tended to overestimate their child's QOL.

Younger children were more likely to have a lower QOL.

Health-related quality of life among pediatric hematopoietic stem cell donors

Transplant outcomes for children and young adults with chronic myeloid leukemia

​Transplant outcomes are similar in children and young adults with CML.

Transplant works better with bone marrow from sibling donors.

Taking TKIs before transplant doesn't affect how well transplant works.

​​​Outcomes of allogeneic hematopoietic cell transplantation in children (<18y) and young adults (18-29y) with chronic myeloid leukemia: A CIBMTR cohort analysis

Transplant can help some children with hypodiploid acute lymphoblastic leukemia

​Children with hypodiploid ALL did worse when they had a transplant later (in their 2nd complete remission).

Children with 43 or fewer chromosomes in their diseased cells had a higher risk of the leukemia coming back and dying after transplant compared to children with 44 or 45 chromosomes.

While more children may live longer because doctors can find better matched donors, disease factors still affect transplant outcomes.

Transplant outcomes for children with hypodiploid acute lymphoblastic leukemia

More teens and young adults with ALL survive after blood or marrow transplant than in the past

​​5-year survival increased over time in teens and young adults and in children.

​​Survival improvements in adolescents and young adults after myeloablative allogeneic transplantation for acute lymphoblastic leukemia

Allo transplant helps some children with neuroblastoma

​Only 4% of patients with neuroblastoma (NBL) get an allo transplant.

20% of patients with NBL who get an allo transplant go into remission for at least 5 years.

Patients with NBL who only get an allo transplant do better than patients who get an auto transplant first and then an allo transplant.

​​Allogeneic hematopoietic cell transplantation for neuroblastoma: The CIBMTR experience

Younger sibling donors better for children and teens needing transplants

​Children and teen patients who get transplants from their younger siblings get less GVHD than patients who get transplants from their older siblings.

For adult patients, it makes no difference if a sibling donor is younger or older.

​​Birth order and transplantation outcome in HLA-identical sibling stem cell transplantations: An analysis on behalf of the Center for International Blood and Marrow Transplantation

Unrelated umbilical cord blood transplants equal to unrelated bone marrow in helping children with acute leukemia

​​​Children with acute leukemia who receive unrelated umbilical-cord blood transplants have outcomes equal to - or in some cases, better than - those treated with bone marrow.

Outcomes of transplantation of unrelated donor umbilical cord blood and bone marrow in children with acute leukaemia: A comparison study


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Chronic Leukemia and Myelodysplastic Syndromes

Chronic leukemia includes chronic lymphocytic leukemia (CLL), chronic myeloid leukemia (CML) and myelodysplastic syndromes (MDS). CLL is primarily an adult disease. It is very rare in children and young adults. About 15,000 people are diagnosed each year in the United States. CML is a relatively common form of leukemia. It affects more than 20,000 people in the United States. There are 6,000 new cases each year. Most cases of CML appear in adults. MDS is uncommon before age 50, and the risk increases as a person gets older. It is most commonly diagnosed in people in their 70s. About 19,000 people are diagnosed with MDS in the United States each year.

Summary (PDF)​Important Points​Full Article

Patients with myelodysplastic syndromes or acute myeloid leukemia may benefit from a standard preparative regimen

​Patients who got a standard preparative regimen were more likely to be cancer-free a year and a half after transplant than patients who got a reduced-intensity regimen.

Myeloablative versus reduced-intensity hematopoietic cell transplantation for acute myeloid leukemia and myelodysplastic syndromes

Cord blood transplant helps some people with myelodysplastic syndromes

​If someone with MDS does not have a matched family member or unrelated donor, a cord blood transplant might help.

Outcomes after umbilical cord blood transplantation for myelodysplastic syndromes

How to make transplant work best for myelodysplastic syndromes

​​​There are many things to think about before using transplant to treat MDS. Doctors and patients should think about the timing, the donor, the preparative regimen, and the cells.

Transplantation for myelodysplastic syndromes: Who, when, and which conditioning regimens

Transplant outcomes for children and young adults with chronic myeloid leukemia

​Transplant outcomes are similar in children and young adults with CML.

Transplant works better with bone marrow from sibling donors.

Taking TKIs before transplant doesn't affect how well transplant works.

Outcomes of allogeneic hematopoietic cell transplantation in children (<18y) and young adults (18-29y) with chronic myeloid leukemia: A CIBMTR cohort analysis


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Graft-versus-Host Disease

Graft-versus-host disease (GVHD) is a common (sometimes serious) side effect of an allogeneic transplant. GVHD happens when cells from the donor (the graft) see the patient’s cells (the host) as different and attack them. GVHD can occur along a spectrum that includes acute or chronic GVHD.

Summary (PDF)​Important Points​Full Article

Better survival over time for patients with acute GVHD

​Treatments for patients with moderate to severe acute GVHD have gotten better over time.

Tacrolimus helped patients with moderate acute GVHD live longer.

​Improved survival after acute graft vs. host disease diagnosis in the modern era

Less chronic GVHD after cord blood transplant for acute leukemia

​Patients had less chronic GVHD after cord blood transplants.

Patients who received ATG had less acute GVHD.

GVHD after umbilical cord transplantation for acute leukemia: An analysis of risk factors and effect on outcomes

A new way to measure acute graft-versus-host disease can help doctors predict transplant outcomes

​The Refined Acute GVHD Risk Score is a way for doctors to predict the likelihood that:

- A patient will be alive 6 months after starting treatment for acute GVHD.

- Acute GVHD will get better with steroids

A refined risk score for acute graft-versus-host disease that predicts response to initial therapy, survival, and transplant-related mortality

New blood test can predict the severity of acute graft-versus-host disease

​Biomarkers can predict whether acute GVHD will be mild or severe and whether it is likely to respond to treatment.

​​A prognostic score for acute graft-versus-host disease based on biomarkers: A multicentre study

Risk score for chronic graft-versus-host disease​Researchers created a chronic GVHD risk score.Chronic GVHD risk score: A Center for International Blood and Marrow Transplant Research analysis


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Lymphoma

Lymphoma includes Hodgkin lymphoma and non-Hodgkin lymphoma (NHL). About 9,000 people are diagnosed with Hodgkin lymphoma in the United States each year. It can occur in both children and adults. But it is more common among young adults and older adults. About 69,000 people are diagnosed with NHL in the United States each year. Most of these people are older than 60.

Summary (PDF)​Important Points​Full Article

Early results suggest people live equally long after half-matched transplants using either peripheral blood or bone marrow

​Scientists followed people for two years after transplants for: Acute leukemias, myelodysplastic syndrome, and lymphomas.

Mobilized peripheral blood stem cells versus unstimulated bone marrow as a graft source for T-cell—replete haploidentical donor transplantation using post-transplant cyclophosphamide

Better transplant results with rituximab for people with B cell non-Hodgkin lymphoma

​Rituximab helped patients live a little longer without the NHL getting worse.

Rituximab made no difference in rates of overall survival, GVHD, and relapse

​​Rituximab-containing reduced-intensity conditioning improves progression-free survival following allogeneic transplantation in B cell non-Hodgkin lymphoma

Transplant from half-matched donors may be as good as matched donors for people with lymphoma

​​People were just as likely to be alive 3 years after transplant whether they had a matched sibling transplant or a haploidentical transplant.

Fewer people got GVHD after a haploidentical transplant.

Reduced-intensity transplantation for lymphomas using haploidentical related donors versus HLA-matched sibling donors: A Center for International Blood and Marrow Transplant Research analysis

More older people with non-Hodgkin lymphoma get transplant

​Transplant is a treatment option for healthy older people with NHL

Allogeneic hematopoietic cell transplantation as curative therapy for patients with non-Hodgkin lymphoma: Increasingly successful application to older patients

Half-matched (haploidentical) transplant for patients with lymphoma

​Patients who had a haploidentical or unrelated donor transplant had about the same 3-year survival.

Patients who had a haploidentical transplant had less chronic GVHD.

​​Reduced-intensity transplantation for lymphomas using haploidentical related donors versus HLA-matched unrelated donors

Patients with relapsed / refractory follicular lymphoma may benefit from a reduced-intensity allogeneic transplant

​Auto transplant or reduced-intensity allo transplant can help patients with follicular lymphoma.

More than 2 years after transplant, patients who get an allo transplant are more likely to survive than patients who get an auto transplant.

Reduced-intensity allografting as first transplantation approach in relapsed/refractory grades one and two follicular lymphoma provides improved outcomes in long-term survivors

​​Allogeneic transplant may be a good treatment option for patients 40 years or older with non-Hodgkin lymphoma

​Reduced-intensity transplant may help patients who are 40 years or older and have NHL.

The chance of getting GVHD did not depend on the patient's age.

Allotransplantation for patients age ≥40 years with non-Hodgkin lymphoma: Encouraging progression-free survival  

Patients with lymphoma have similar survival after transplant whether the unrelated donor is matched, mismatched, or cord blood

​3-year survival was about the same no matter what type of unrelated donor a patient had: matched, mismatched, or cord blood.

Alternative donors extend transplantation for patients with lymphoma who lack an HLA matched donor

Allo transplant helps some patients with DLBCL and follicular lymphoma when chemotherapy and radiation don't

​25% of patients with either diffuse large B cell lymphoma (DLBCL) or grade 3 follicular lymphoma achieved durable remission after an allo transplant when chemotherapy and radiation alone didn't work.

Patients are just as likely to survive after transplant with a low dose of chemotherapy and radiation before transplant as with a high dose.

Patients have fewer serious side effects from a low dose of chemotherapy and radiation.

Impact of pretransplantation conditioning regimens on outcomes of allogeneic transplantation for chemotherapy-unresponsive diffuse large B cell lymphoma and grade III follicular lymphoma

​​Allo transplant helps some patients with mantle cell lymphoma when chemotherapy and radiation don't

​​25% of patients with mantle cell lymphoma went into remission after an allo transplant when chemotherapy and radiation alone didn't work.

Patients can do just as well after transplant with a low dose of chemotherapy and radiation as they would with a high dose.

Patients have fewer serious side effects from a low dose of chemotherapy and radiation.

Allogeneic hematopoietic cell transplantation for chemotherapy-unresponsive mantle cell lymphoma: A cohort analysis from the Center for International Blood and Marrow Transplant Research

Outcomes of non-Hodgkin lymphoma patients receiving transplantations from related vs. unrelated donors​Some patients with non-Hodgkin lymphoma can get transplant even if they don't have a matched sibling donor.Alternate donor hematopoietic cell transplantation (HCT) in non-Hodgkin lymphoma using lower intensity conditioning: A report from the CIBMTR


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Multiple Myeloma

Multiple myeloma is a cancer of the plasma cells. Plasma cells are a part of the immune system. More than 22,000 people in the United States are diagnosed with multiple myeloma each year. Most people who have the disease are age 65 or older.

Summary (PDF)​Important Points​Full Article
Auto transplants are safe and effective for people with multiple myeloma and damaged kidneys

​Auto transplants are safe and work equally well in people with multiple myeloma and damaged kidneys.

The treatment can help some people stop dialysis treatments.

Higher doses of melphalan can improve results.

Autologous hematopoietic cell transplantation for multiple myeloma patients with renal insufficiency: A Center for International Blood and Marrow Transplant Research analysis

Younger adults with high risk multiple myeloma may benefit from allo transplant

​Allo transplant may help people with high risk myeloma or myeloma that comes back early after an auto transplant live longer without the disease.

Younger people and people with no myeloma signs or symptoms before allo transplant lived longer without the disease.

​Allogeneic hematopoietic cell transplantation in multiple myeloma: Impact of disease risk and post allograft minimal residual disease on survival

Guidelines for transplant and multiple myeloma

​​Doctors should consider recommending an autologous transplant for most patients with multiple myeloma.

Hematopoietic stem cell transplantation for multiple myeloma: Guidelines from the ASBMT

Second transplant helpful for myeloma relapse

​25% of myeloma patients whose cancer returned after their first transplant went into a complete remission after a second transplant.

Patients who were in remission for at least 1.5 years after their first transplant lived almost twice as long after their second transplant as patients who relapsed in less than 1.5 years.

Salvage second hematopoietic cell transplantation in myeloma


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Other Diseases

Transplant is also used to treat other diseases, such as multiple sclerosis and sickle cell disease. Multiple sclerosis is a chronic, often disabling disease, that attacks the central nervous system (brain and spinal cord). More than 2.3 million people are affected by MS worldwide. Most are diagnosed between the ages of 20 and 50. Women get MS more often than men. Sickle cell disease is an inherited disease of the red blood cells. In the United States, it affects about 70,000-100,000 people. It is most common among people with African or Hispanic ancestry.

Summary (PDF)​Important Points​Full Article

Auto transplant helps some people with multiple sclerosis

​For almost half of people who got auto transplant, their MS didn't get worse for 5 years after transplant.

Long-term outcomes after autologous hematopoietic stem cell transplantation for multiple sclerosis

​Stem cell transplantation "vital option" for sickle cell patients

​Some patients with sickle cell disease do well after a transplant from a matched sibling.

Many do not have symptoms of sickle cell disease for at least 5 years after transplant.

Matched-related donor transplantation for sickle cell disease: Report from the Center for International Blood and Marrow Transplant Research


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Other Topics related to Transplant

Access to Transplant

Doctors want to make transplant available to everyone who needs it. Research helps doctors know which patients are healthy enough and would benefit from transplant. It also helps doctors know when people don’t have access to transplant and understand why.

Summary (PDF)​Important Points​Full Article

Auto transplants are safe and effective for people with multiple myeloma and damaged kidneys

​Auto transplants are safe and work equally well in people with multiple myeloma and damaged kidneys.

The treatment can help some people stop dialysis treatments.

Higher doses of melphalan can improve results.

​​Autologous hematopoietic cell transplantation for multiple myeloma patients with renal insufficiency: A Center for International Blood and Marrow Transplant Research analysis

More older people with non-Hodgkin lymphoma get transplant

​Transplant is a treatment option for healthy older people with NHL.

Allogeneic hematopoietic cell tansplantation as curative therapy for patients with non-Hodgkin lymphoma: Inceasingly successful application to older patients

Experts develop transplant guidelines​These recommendations are important guides for doctors and patients as they talk about whether BMT is a treatment option.Indications for autologous and allogeneic hematopoietic cell transplantation: Guidelines from the American Society for Blood and Marrow Transplantation

Most patients who need an allo transplant can Find a well matched donor

​​Most patients can find a well matched or a very well matched available adult donor in the Be The Match Registry.

It is important to find the best donor as soon as possible, so the transplant isn't delayed. If a very well matched donor isn't available, it is better to use a well matched donor than to wait to try to find a very well matched one.

HLA match likelihoods for hematopoietic stem-cell grafts in the U.S. registry
​​A quicker transplant with the best donor available is often the better choice​Patients may have better transplant results if they have the transplant sooner with the best donor available, rather than wait for a perfectly-matched donor while their cancer progresses.High-resolution donor-recipient HLA matching contributes to the success of unrelated donor marrow transplantation
​Access to bone marrow and stem cell transplant differs among different groups

​Transplants are used more often to treat leukemia, lymphoma, and multiple myeloma in Whites than in Blacks.

Men get transplants more often than women.

​Access to hematopoietic stem cell transplantation: Effect of race and sex

Race and outcomes of autologous hematopoietic cell transplantation for multiple myeloma


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Donor Health and Safety

Doctors are committed to making stem cell donation as safe as possible. More than 99% of donors experience a full recovery.

Summary (PDF)​Important Points​Full Article
​Donating blood-forming cells twice is safe for donors

​Your doctor can help you feel well during a second donation.

Donating twice is rare.

Donor experiences of second marrow or peripheral blood stem cellcollection mirror the first, but CD34+ yields are less

After donating blood-forming cells, older people report similar quality of life as younger people

​Siblings 60 and older can donate blood-forming cells.

Older donors have similar quality of life after donation as younger donors.

Health-related quality of life among older related hematopoietic stem cell donors (>60 years) is equivalent to that of younger related donors (18 to 60 years): A related donor safety study

Some children who donate cells to a brother or a sister have a lower quality of life and need extra support

​About 20% of donors (1 in 5) at each time point had very poor QOL.

Parents tended to overestimate their child's QOL.

Younger children were more likely to have a lower QOL.

Health-related quality of life among pediatric hematopoietic stem cell donors

How to decide whether a child can safely donate blood-forming cells to a family member​Experts make recommendations to help doctors and parents protect children who might donate blood-forming cells to a sick family member.Determination of eligibility in related pediatric hematopoietic cell donors: ethical and clinical considerations. Recommendations from a working group of the Worldwide Network for Blood and Marrow Transplantation Association

​​Bone marrow donors have more side effects at hospitals that do fewer bone marrow collections

​Bone marrow donors had more side effects at hospitals that did fewer bone marrow collections.

​​An analysis of the effect of race, socioeconomic status and center size on unrelated NMDP donor outcomes: Donor toxicities are more common at low volume bone marrow collection centers

Very few donors have severe side effects from donation

​Less than 1% of donors have severe side effects from donation.

Bone marrow donors have severe side effects 3 times more often than blood stem cell donors.

Blood stem cell donors who get G-CSF do NOT get cancer, an autoimmune illness, or a stroke more often than those who don't get G-CSF.

Lower risk of serious adverse events and no increased risk of cancer after PBSC versus bone marrow donation


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Donor Selection

Doctors always try to find the best donor for a person who needs transplant. Research helps doctors know which type of person is best: related vs. unrelated, very well matched vs. half matched, older vs. younger. Research also helps doctors know which stem cell source is best: bone marrow vs. peripheral blood vs. cord blood.

Summary (PDF)​Important Points​Full Article

A transplant from an unrelated donor can treat acute lymphoblastic leukemia

​​New research may make it possible for more people with acute lymphoblastic leukemia (ALL) to get life-saving transplants.

In the past, a transplant using blood-forming cells from a sibling was the only well-tested transplant option.

New research shows that a transplant from an unrelated donor can help people with ALL live equally long as a transplant from a sibling.

Comparing outcomes of matched related donor and matched unrelated donor hematopoietic cell transplants in adults with B-cell acute lymphoblastic leukemia

Transplant may be better when it uses bone marrow compared to peripheral blood stem cells from unrelated donors

​At 5 years after transplant from an unrelated conor, people who got bone marrow had better quality of life than people who got PBSC. People who got bone marrow:

- Were more likely to be back at work.

- Said they felt better emotionally.

- Had fewer symptoms of chronic GVHD.

​Comparison of patient-reported outcomes in 5-year survivors who received bone marrow vs peripheral blood unrelated donor transplantation: Long-term follow-up of a randomized clinical trial

Comparing 2 types of blood and marrow transplant: Double cord blood and haplo-cord

​For both types of transplant, about half of patients were alive 1 year after transplant.

Patients who had a haplo-cord transplant had less GVHD, and the disease came back less often.

Reduced intensity haplo plus single cord transplant compared to double cord transplant: Improved engraftment and graft-versus-host disease-free, relapse-free survival

Younger unrelated donors are better for transplant patients

​The best unrelated donors are aged 18-32 years old and closely HLA-matched to the patient.

​​The effect of donor characteristics on survival after unrelated donor transplantation for hematologic malignancy

Half-matched (haploidentical) transplant for patients with lymphoma

​Patients who had a haploidentical or unrelated donor transplant had about the same 3-year survival.

Patients who had a haploidentical transplant had less chronic GVHD.

Reduced-intensity transplantation for lymphomas using haploidentical related donors versus HLA-matched unrelated

Patients with lymphoma have similar survival after transplant whether the unrelated donor is matched, mismatched, or cord blood

​​3-year survival was about the same no matter what type of unrelated donor a patient had: matched, mismatched, or cord blood.

Alternative donors extend transplantation for patients with lymphoma who lack an HLA matched donor

Most patients who need an allo transplant can find a well matched donor

​​​Most patients can find a well matched or a very well matched available adult donor in the Be The Match Registry.

It is important to find the best donor as soon as possible, so the transplant isn't delayed. If a very well matched donor isn't available, it is better to use a well matched donor than to wait to try to find a very well matched one.

​​HLA match likelihoods for hematopoietic stem-cell grafts in the U.S. registry

Older sibling donors are better than younger, unrelated donors for older patients

​An older sibling donor is better than a younger, unrelated donor for patients who are 50 or older.

Looking at patients with a high performance score (healthier patients): Patients with older sibling donors survive longer, relapse less, and get less GVHD than patients with younger, unrelated volunteer donors.

Who is the better donor for older hematopoietic transplant recipients: An older-aged sibling or a young, matched unrelated volunteer?

Younger sibling donors better for children and teens needing transplants

​Children and teen patients who get transplants from their younger siblings get less GVHD than patients who get transplants from their older siblings.

For adult patients, it makes no difference if a sibling donor is younger or older.

Birth order and transplantation outcome in HLA-identical sibling stem cell transplantations: An analysis on behalf of the Center for International Blood and Marrow Transplantation

SNPs - New information for matching patients and donors for transplant

​Many complications of HLA-mismatched transplantation are the result of genes that are not currently tested in the pre-transplant evaluation process of donors and patients.

Scientists use SNPs, which are very small changes in the DNA genetic code, to locate unknown genes.

Some SNPs are associated with better results after transplantation than other SNPs.

Mapping MHC haplotype effects in unrelated donor hematopoietic cell transplantation

Similar survival for leukemia patients receiving transplants from related vs. unrelated donors

​Patients with leukemia who get a transplant from a well matched unrelated donor or from an unrelated donor with a single mismatch should have similar survival to patients who have a related donor.

Outcomes after matched unrelated donor versus identical sibling hematopoietic cell transplantation in adults with acute myelogenous leukemia

​​Outcomes of non-Hodgkin lymphoma patients receiving transplantations from related vs. unrelated donors

​Some patients with non-Hodgkin lymphoma can get transplant even if they don't have a matched sibling donor.

Alternate donor hematopoietic cell transplantation (HCT) in non-Hodgkin lymphoma using lower intensity conditioning: A report from the CIBMTR

Umbilical cord blood as transplantation graft source for adults with acute leukemia

​Adults with acute leukemia who get an umbilical cord blood transplant do as well as adults who get a bone marrow transplant or a peripheral blood stem cell transplant.Effect of graft source on unrelated donor haemopoietic stem-cell transplantation in adults with acute leukaemia: A retrospective analysis

Unrelated umbilical cord blood transplants equal to unrelated bone marrow in helping children with acute leukemia

​Children with acute leukemia who receive unrelated umbilical-cord blood transplants have outcomes equal to - or in some cases, better than - those treated with bone marrow.

Outcomes of transplantation of unrelated donor umbilical cord blood and bone marrow in children with acute leukaemia: A comparison study

​​A quicker transplant with the best donor available is often the better choice

​Patients may have better transplant results if they have the transplant sooner with the best donor available, rather than wait for a perfectly-matched donor while their cancer progresses.

​​High-resolution donor-recipient HLA matching contributes to the success of unrelated donor marrow transplantation


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HLA Matching and Biologic Factors

HLA matching is used to match patients and donors for transplant. Usually a very close match is best. But sometimes a half-matched transplant is best. Research helps doctors know which match is best.

Summary (PDF)​Important Points​Full Article

Transplant from half-matched donors may be as good as matched donors for people with lymphoma

​​​People were just as likely to be alive 3 years after transplant whether they had a matched sibling transplant or a haploidentical transplant.

Fewer people got GVHD after a haploidentical transplant.

Reduced-intensity transplantation for lymphomas using haploidentical related donors versus HLA-mathced sibling donors: A Center for International Blood and Marrow Transplant Research analysis


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Late Effects and Quality of Life

A transplant can have a long-term impact on a person’s health and wellbeing. Late effects are health problems that can happen months or years after treatment. For example, treatment can affect fertility, physical and emotional health, and risk of other cancers.

Summary (PDF)​Important Points​Full Article
Quick survey checks your quality of lifeTalk with your doctor about how you are feeling physically and emotionally.

PROMIS measures can be used to assess symptoms and function in long-term hematopoietic cell transplantation survivors

After transplant, some people have problems focusing ​Cognitive changes after BMT may include altered attention, focus, learning, memory and thinking.
Your doctor can help.

Neurocognitive dysfunction in hematopoietic cell transplant recipients: Expert review from the Late Effects and Quality of Life Working Committee of the CIBMTR and Complications and Quality of Life Working party of the EBMT

Common late effects after transplant in very young children

​30% of very young BMT recipients have organ damage or other late effects.

Common late effects are delayed growth, cataracts, and hypothyroidism.

Full-body radiation increases the chance of getting these late effects.

Survival and late effects after allogeneic hematopoietic cell transplantation for hematologic malignancy at less than three years of age

Guidelines on cancer screening for transplant recipients​

​Common places for new cancers after transplant are the mouth, skin, breast, and thyroid.

Both allogeneic and autologous transplant recipients have a higher chance of getting a new cancer.

Secondary solid cancer screening following hematopoietic cell transplantation

​​Fertility preservation options before transplant

​Tell your doctor right away if you want to talk about fertility preservation.

Clinical guide to fertility preservation in hematopoietic cell transplant recipients

Doctors surveyed about talking to patients about fertility

​Hematopoietic cell transplantation can cause patients to become infertile. However, there are options for fertility preservation, which allow patients to have children in the future.

Most doctors who responded to the survey feel comfortable talking with patients about fertility preservation.

Patients must tell their doctor if they want to talk about fertility preservation.

Physician perceptions and practice patterns regarding fertility preservation in hematopoietic cell transplant recipients

​Medical guidelines for survivors of stem cell transplantation​This research article describes best practices for follow-up, prevention, and screening of late complications.Recommended screening and preventive practices for long-term survivors after hematopoietic cell transplantation
Long-term survival after transplantation

​Patients are more likely to survive long-term after transplant if:

- They get transplant sooner.

- They have better disease control and immune system support.

- They get less toxic therapy.

Long-term survival and late deaths after allogeneic hematopoietic cell transplantation
Spouses, partners share mental distress of cancer​Spouses of cancer patients suffer distress and depression at levels equal to - or greater than - their partners.Late effects of cancer and hematopoietic stem-cell transplantation on spouses or partners compared with survivors and survivor-matched controls
​Improving health for long‐term survivors of cancer and transplants​Bone marrow or stem cell transplant survivors should actively protect their health.
This can help speed up their recovery and improve the quality of their life.
It can also lower their risk of developing health problems in later years.
​​The preventive health behaviors of long-term survivors of cancer and hematopoietic stem cell transplantation compared with matched controls


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Social and Financial Aspects of Transplant

Transplant affects more than a person’s physical health. It affects emotional health, ability to work, and finances. Transplant also affects more than the patient. It affects the entire family.

Summary (PDF)​Important Points​Full Article

Transplant often affects family finances

​At 2 years after transplant:

- Most patients and caregivers thought transplant affected their family finances a medium or large amount.

- Half of patients who worked before transplant were back to work.

​​Financial impact of allogeneic hematopoietic cell transplantation on patients and families over 2 years: Results from a multicenter pilot study

​​A survey that asks patients about their physical health before transplant may predict how they’ll do after transplant

​How patients feel physically before and after transplant affects transplant outcomes.

Patient-reported physical functioning predicts the success of hematopoietic cell transplantation (BMT CTN 0902)

Experts develop transplant guidelines

​These recommendations are important guides for doctors and patients as they talk about whether BMT is a treatment option.

Indications for autologous and allogeneic hematopoietic cell transplantation: Guidelines from the American Society for Blood and Marrow Transplantation

Individualized care plans for transplant recipients: An example of patient-centered research

​​Patients are involved in every step of the research process.

Researchers think the care plans will help patients be healthier and less stressed after transplant.

Patient centeredness and engagement in quality-of-care oncology research

National survey of transplant center resources, staff, and structure

​Different transplant centers have different resources, staff, and structure.

National survey of hematopoietic cell transplantation center personnel, infrastructure, and models of care delivery

Patients with myeloma or lymphoma can have excellent outcomes after an outpatient autologous transplant

​Outcomes (results) were similar in the inpatient and outpatient transplant groups.

Safety of outpatient autologous hematopoietic cell transplantation for multiple myeloma and lymphoma

Spouses, partners share mental distress of cancer

​Spouses of cancer patients suffer distress and depression at levels equal to - or greater than - their partners.

Late effects of cancer and hematopoietic stem-cell transplantation on spouses or partners compared with survivors and survivor-matched controls


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Trends in Transplant

Transplant treatment and outcomes change over time as doctors learn more about what works best.

Summary (PDF)​Important Points​Full Article

Treatment helps children and teens with acute leukemia thrive after cord blood transplants

​The TCF treatment regimen before cord blood transplant helped young people with acute leukemia live longer.

Umbilical cord blood transplantation in children with acute leukemia: Impact of conditioning on transplantation outcomes

The number of allogeneic transplants for people age 70 years and older are increasing, and outcomes are improving

​More older people got BMT between 2000 and 2013.

BMT results for older people have gotten better between 2000 and 2013.

Increasing use of allogeneic hematopoietic cell transplantation in patients aged 70 years and older in the United States

Better survival over time for patients with acute GVHD

​Treatments for patients with moderate to severe acute GVHD have gotten better over time.

Tacrolimus helped patients with moderate acute GVHD live longer.

​Improved survival after acute graft vs. host disease diagnosis in the modern era

More patients who have a transplant from an unrelated donor survive than in the past

​​3-year survival after transplant from an unrelated donor has increased over time.

Significant improvement in survival after unrelated donor hematopoietic cell transplantation in the recent era


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Last Updated: 6/18/2018 12:30 PM
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