Allogeneic Bone Marrow Transplant — A Donor Immune System as Therapy

Indication and donor selection

The decision to proceed depends on disease risk, response to prior treatment, patient age and fitness, and donor availability. HLA typing is performed for siblings and, when needed, unrelated registries. Alternative donors, including haplo-identical family donors and cord blood, expand options. Pre-transplant counselling covers risks, expected recovery and long-term effects.

• Disease risk and response assessment
• Patient fitness and comorbidity review
• HLA typing and donor search
• Alternative donor options when needed
• Detailed informed consent and fertility counselling

Transplant course and follow-up

Conditioning prepares the marrow and immune system for donor cells. The graft is infused, and engraftment is monitored. Prophylaxis and treatment for infection and GVHD are central. Long-term follow-up includes chimerism monitoring, vaccination, organ function review, and surveillance for relapse and secondary complications.

• Conditioning and donor stem cell infusion
• Engraftment and chimerism monitoring
• Infection prophylaxis and treatment
• GVHD prevention, diagnosis and management
• Long-term survivorship and relapse surveillance

Guidelines referenced:

• EBMT/ESH handbook on haematopoietic stem cell transplantation
• NCCN Guidelines — Acute Leukemias and MDS
• ASH guidelines on GVHD prophylaxis and management