Short-term toxicity in pediatric marrow transplantation using related and unrelated donors

The use of volunteer, unrelated donors has substantially increased the numb er of potential donors for pediatric marrow transplantation during the past few years. We describe our single institution experience of short-term tox icity after pediatric marrow transplantation using sibling or unrelated don ors. Fully matched (A, B and DR loci) donors mere employed in 94% of the ca ses in both groups. Conditioning of similar intensity and uniform supportiv e care were employed in the two groups. Both primary non-engraftment and se condary graft failure were more common among recipients of unmanipulated UR D grafts. Clinically significant (grades III-IV) acute GVHD and toxic morta lity during the immediate post-transplant period were also higher in this g roup of patients. Pediatric marrow transplantation using volunteer, unrelat ed donors appears to be associated with an increased incidence of procedure -related toxic complications.