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

TitleTransmission of donor illness by stem cell transplantation: should screening be different in older donors?
Publication TypeJournal Article
Year of Publication2004
AuthorsNiederwieser D, Gentilini C, Hegenbart U, Lange T, Moosmann P, Ponisch W, Al-Ali H, Raida M, Ljungman P, Tyndall A, Urbano-Ispizua A, Lazarus HM, Gratwohl A
JournalBone Marrow Transplant
Pagination657 - 65
Date PublishedOct
Accession Number15334048
Keywords*Aging, *Donor Selection, *Tissue Donors, Age Factors, Autoimmune Diseases / etiology, Blood Transfusion, Bone Marrow Cells / microbiology / parasitology / virology, Disease Transmission / prevention & control, Hematologic Diseases / etiology / therapy, Histocompatibility Testing, Humans, Leukemia / etiology / therapy, Mass Screening, Research Support, Non-U.S. Gov't, Stem Cell Transplantation / *adverse effects / *methods

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.

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