100% Sibling Match

[Bossywife]

Does a 100% sibling match donor mean that there is a less chance of GVHD? Or is it less chance of a failed transplant? Or is there any benefit to it?

[rar]

I had a 10/10 match. I was told I had somewhat less of a chance of relapse. About the same chance of GVHD. Some GVH is good in that it lessens the chance of relapse. After almost 2 and a half years my doctor says that I have almost no chance of relapse. Your millage may vary.

Ray

[bailie]

I think it is not consistent from person to person. It seems like everything about these diseases produces individual results. I don't think all of the answers are available. I had a match from a person from Germany (not related) and had almost zero GVHD. I had a little skin rash that lasted maybe three weeks that caused me no problems. I had some itching on my face and scalp. That was about the extent of my GVHD. They did mention that my donor was 20 years old and they said the younger the better, perhaps because more stem cells are available at that age. Or, they might have just been trying to make me feel good about my donor.

[Neil Cuadra]

This is just speculation, but it seems logical to me that a sibling match is a better match than an "equally matched" unrelated donor because of all of the genetic markers that they don't test for.

On the other hand, if the cause of your disease has any genetic component, such as a genetic predisposition that led to the illness in the first place, then a sibling may have the same genetic disadvantage. I wonder if doctors are ever concerned about this.

In your husband's case, there might be a tradeoff between having his brother as donor and having a younger but unrelated donor.

[bailie]

Neil that is a very good comment. I have had that conversation ("such as a genetic predisposition that led to the illness in the first place") with my doctors about that a couple of times. There is just not a lot of testing for unknown genetic problems that might develop. My doctor expressed that is a weakness.

[rar]

I think this is the answer to your question. 3 year survival for a peripheral blood 100% HLA matched sibling for MDSRAEB transplant is 45.1%. For same except unrelated is 38.9%. So as I said there is an advantage for siibling vs. unrelated. I have no such data for GVHD.

Ray

[GoodDay5150]

I had a 10/10 match from an unrelated donor. I believe that a related sibling match lessens the chances, and or severity of GVHD. The nurse coordinator that I worked w/ sd that I had the absolute best match possible. She also told me abt the testing that was done pre-transplant, and what interactions between the donor and recipient may occur. Thinking about this 5 yrs later, I am assuming that she was referring to GVHD, but she did not use that term with me. It is true that most dr's want to see at least some GVHD to show that your new immune system is engrafting as it should.

Mario