By H. Joachim Deeg M.D., Hans-Georg Klingemann M.D., Gordon L. Phillips M.D. (auth.)
In 1988 we awarded our advisor to Bone Marrow Transplan tation. The reception has been enthusiastic and we now have re ceived a flood of serious reviews, feedback and requests to supply an replace in due time. even supposing numerous books on marrow transplantation have lately been released, their scope and target have normally been varied. as a result, now we have determined to organize a moment variation of the consultant. Our target used to be to take care of a quick, concise textual content which by no means theless could contain adjustments that experience happened during the last 4 or 5 years. we've got streamlined the outline of pretransplant concerns, by way of condensing sections into one (Treatment making plans and Timing of Transplantation). This additionally facilitated the evaluation of arguable symptoms for marrow transplantation, for instance in sufferers with acute myelogenous leukemia in first chemotherapy-induced remission. we have now up-to-date the bankruptcy facing conditioning regimens and feature multiplied the part on donor choice, particularly in regard to the present point of tissue typing and the identity of unrelated volunteer donors. within the bankruptcy on assortment, processing, and infusion of marrow, now we have integrated contemporary advancements, for instance, using closed platforms for marrow harvesting and processing and using reliable part separation of stem cells.
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Additional resources for A Guide to Bone Marrow Transplantation
In general, auto transplants are preferred in older patients, regardless of the presence of suitable donors. Also, for most malignant solid tumors (perhaps excluding neuroblastoma), the probability of cure is low with current conditioning regimens and the risks associated with allogeneic marrow transplantation do not appear to routinely justify the use of this modality. Of course, not all patients are eligible for both types of transplant, due to relatively advanced age, histocompatibility limitations, marrow contamination with malignant cells or other major treatment-related complications such as persistent aplasia, myelodysplasia, and myelofibrosis.
The decision in favor of transplantation, especially allogeneic transplantation, is made more easily in pediatric patients or young adults than in older patients. The decision making process should always involve an experienced transplant team. References Anasetti C, Amos D, Beatty PG, Appelbaum FR, Bensinger W, Buckner CD, Clift R, Doney K, Martin PJ, Mickelson E, Nisperos B, O'Quigley J, Ramberg R, Sanders JE, Stewart P, Storb R, Sullivan KM, Witherspoon RP, Thomas ED, Hansen JA (1989) Effect of HLA compatibility on engraftment of bone marrow transplants in patients with leukemia or lymphoma.
Moreover, certain less obvious points should be detailed; for example, an acute leukemia patient may have been a reasonable candidate for transplantation soon after first achieving an initial complete remission, but be much le~s so after a year of continuous remission. Also, although the chief reason for considering a marrow transplant is almost always the possibility of cure, some patients arrive with the misconception that marrow transplantation is invariably curative; this idea must be dispelled.
A Guide to Bone Marrow Transplantation by H. Joachim Deeg M.D., Hans-Georg Klingemann M.D., Gordon L. Phillips M.D. (auth.)