Abstract
We reported three children who underwent bone marrow transplantation (BMT) from HLA-matched unrelated volunteer donors registered at the Tokai Marrow Donor Bank. Primary diseases were chronic myelogenous leukemia in accelerated phase (case 1), Ph1-positive acute lymphoblastic leukemia in first complete remission (case 2) and metachromatic leukodystrophy (case 3). The conditioning regimen consisted of etoposide cyclophosphamide (CY) -I-total body irradiation for cases 1 and 2, and busulfan+CY for case 3. Antilymphocyte globulin was administered to prevent graft failure for case 3. Graft-versus-host disease (GVHD) prophylaxis consisted of methotrexate and cyclosporin. Engraftment was achieved in all three cases. One patient developed grade 2 acute GVHD and chronic GVHD. Case 2 relapsed 200 days after BMT and died 365 days after BMT. Two other patients have been alive without complications associated with BMT for 25 and 14 months following transplantation, respectively. Although some problems including the procedure of marrow donor selection and the prevention of graft failure and GVHD remain to be resolved, transplantation from unrelated donors can benefit the children who require allogeneic BMT but lack a suitable related donor.
