[Relentless Against SAA]

AAteen,
Thanks for answering.
We get different opinions from different members of our transplant team. The doc has said that he would like to use peripheral blood for stem cells because Aplastic Anemia patients have issues with rejection. We hear complete opposite opinions from 2 of the nurse transplant coordinators who work with him (I have never pointed this out to any of them). The coordinators say that in Aplastic Anemia patients you prefer marrow over peripheral blood as a source of stem cells. There is less GVHD with marrow donation. In Leukemia Some GVHD is good to keep the Leukemia in check but with AA you want to avoid all GVHD. The two coordinators say that there should be communication with the donor as to why marrow is really beneficial to the patient. Both coordinators say that many donors understand they are saving a life and are willing to donate marrow, not all, but many.

I recently read an article published 4-19-12 by Neal Young in which he states that rejection is now less problematic, probably because patients are moving faster to transplant and avoiding heavy transfusion burdens, less immunogenic blood products and more efficacious conditioning regimens. Later in the article he states " In SAA GVHD is unequivocally to be avoided and its occurrence decreases survival and long term quality of life. Thus bone marrow is preferred source of stem cells in SAA. The article is titled " How I treat acquired Aplastic Anemia". It is packed with wonderful information. I plan on showing our transplant doc this article and give him a chance to explain his position. I am sure he will love that but I have to understand his reasoning.

Our doc didn't mention any concerns about a B mismatch either. Yet, I am terrified about not having a 10/10 match out there somewhere just in case we need it. Please let me know what your doc has to say at next appt.