Transmission of donor illness by stem cell transplantation: should screening be different in older donors?

Niederwieser, D.; Gentilini, C.; Hegenbart, U.; Lange, T.; Moosmann, P.; Pönisch, W.; Al-Ali, H.; Raida, M.; Ljungman, P.; Tyndall, A.; Urbano-Ispizua, A.; Lazarus, H. M.; Gratwohl, A.

Summary:With increasing donor age, the potential of transmitting diseases from donor to recipient reaches new dimensions. Potentially transmittable diseases from donors include infections, congenital disorders, and acquired illnesses like autoimmune diseases or malignancies of hematological or nonhematological origin. While established nonmalignant or malignant diseases might be easy to discover, early-stage hematological diseases like CML, light-chain multiple myelomas, aleukemic leukemias, occult myelodysplastic syndromes and other malignant and nonmalignant diseases might not be detectable by routine screening but only by invasive, new and/or expensive diagnostic tests. In the following article, we propose recommendations for donor work-up, taking into consideration the age of the donors. In contrast to blood transfusions, stem cells from donors with abnormal findings might still be acceptable for HCT, when no other options are available and life expectancy is limited. This issue is discussed in detail in relation to the available donor and stem cell source. Finally, the recommendations presented here aim at harmonized worldwide work-up for donors to insure high standard quality.Bone Marrow Transplantation (2004) 34, 657-665. doi:10.1038/sj.bmt.1704588 Published online 30 August 2004

STEM cells; TRANSPLANTATION of organs, tissues, etc.; AUTOIMMUNE diseases; MULTIPLE myeloma; B cell lymphoma; MYELODYSPLASTIC syndromes; BONE marrow diseases; DYSPLASIA; HOSPITAL transfusion committees

Bone Marrow Transplantation, 2004, Vol 34, Issue 8, p657

0268-3369

Academic Journal

10.1038/sj.bmt.1704588