A SURVEY OF USE OF UNRELATED VOLUNTEER DONOR BONE-MARROW TRANSPLANTATION AT 46 CENTERS WORLDWIDE, 1989-93

Unrelated donor bone marrow transplantation is increasingly used to tr eat haemopoietic disorders where no HLA-identical sibling is available . The International Marrow Unrelated Search and Transplant Study has c ollected core data on consecutive unrelated donor BMT (UD-BMT) and HLA -identical sibling donor BMT (ID-BMT) performed in 46 participating ce ntres world-wide between March 1989 and February 1993. Eighteen UD-BMT were performed in the first 6-month period in 14 participating centre s, while in the last period there were 103 UD-BMT in 46 centres. The p ercentage of BMT recipients with the following diagnoses were: bone ma rrow failure UD-BMT 15% and ID-BMT 11%; AML 13% and 27%; ALL 18% and 1 7%; CML 48% and 31%; and other diseases 7% and 14%. Thirty-eight per c ent of UD-BMT recipients had advanced disease compared with only 23% o f ID-BMT recipients. Thirty six per cent of UD-BMT compared with 21% o f ID-BMT recipients were under 16 years old, More extreme differences in pre-transplant clinical characteristics between UD and ID-BMT recip ients were found when diagnosis and stage of disease were considered t ogether, This survey indicates how UD and ID-BMT are currently used in the treatment of haematological disease; however, longer follow-up is required to assess the value of UD-BMT in the management of patients with bone marrow disorders.