0
Commentary |

The Next Frontier for Stem Cell Transplantation:  Finding a Donor for All

Lucy A. Godley, MD, PhD; Koen van Besien, MD, PhD
JAMA. 2010;303(14):1421-1422. doi:10.1001/jama.2010.413.
Text Size: A A A
Published online

Extract

Current treatment strategies for patients with acquired or congenital disorders of hematopoiesis, immune system diseases, or high-risk or recurrent hematological malignancies often involve allogeneic hematopoietic stem cell transplantation (HSCT). Identifying HLA-identical siblings is often difficult because each full sibling has only a 25% chance of matching the patient. Constraints surrounding the siblings, such as the number of full siblings, their availability, and, increasingly, their health, limit the use of HSCT for many patients who might otherwise benefit. For such patients, searches of the National Marrow Donor Registry and other registries worldwide attempt to identify unrelated donors who match the patient molecularly for at least 4, and possibly 5, HLA loci (HLA-A, -B, -C, -DR, and possibly -DQ).1 Identifying HLA-identical donors using these high-resolution typing methods has resulted in marked improvements in outcomes of matched unrelated HSCT. But for many patients and their physicians, donor identification remains a major hurdle to the use of HSCT, especially for members of ethnic minority groups who often have rare HLA types not represented in the registries.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 7

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Jobs
brightcove.createExperiences();