Matched Sibling Donor Transplantation

Allogeneic transplantation is available to only a minority of patients (around 30%). With the general improvement in the outcomes of stem cell transplantation, the overall survival (OS) for matched sibling donor transplantation has been as good as 85-90% (Figure 41.6).96'97 Even better results were reported in children, in whom stem cell transplantation appears to be more effective in improving survival than does immunosuppression,98 making this procedure a treatment of choice for children with severe AA and a matched sibling donor. However, the typical decrease in the OS is observed with increasing age of the recipient, making the therapeutic decision for older patients a challenge. Children and young adults with a matched sibling donor should be offered stem cell transplantation as a first therapeutic option.

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