Northern California's Comprehensive Thalassemia Center at at Children's Hospital Oakland

Bone Marrow Transplant

Donor Cord Blood

Human Leukocyte Antigen


Lucarelli Staging System for BMT
Stage	Criteria	Survival	Event-free survival
I	absence of hepatomegaly (enlargeed liver), regular iron chelation before transplant, absence of fibrosis in pretransplant liver biopsy result	96%	90%
II	hepatomegaly, a history of irregular iron chelation before transplant, histological evidence of liver fibrosis, or various combinations of the above	86%	82%
III	all of the following: large liver, poor compliance with chelation therapy, liver damage	76%	53%
Adult	Class II or III, irregular iron chelation, with a range of clinical symptoms and other diagnoses	65%	63%

Bone Marrow Transplant (3)

32% of adults expired as a direct result of complications of the bone marrow transplantation. Recently the Lucarelli group reported on bone marrow recipients who have "mixed chimerism," meaning these individuals have both their own thalassemic blood cells and donor blood cells. In these cases about one third each either rejected the transplant, totally engrafted the donor cells or remained a mixed chimera. The latter two groups required no blood transfusions. It should be noted that the outcomes at the Pesaro Centre are better than any other center reporting bone marrow transplant results for beta thalassemia major. This may be in part due to the homogeneity of the population.

Northern Comprehensive Thalassemia Center