Transplant date fixed -countdown start

[pdiitdelhi0204]

Dear All,
My 24 month old son, aplastic anemia patient, has been planned for Matched Unrelated Transplant at Christian Medical College, Vellore, India. We got donor from USA which 10/10 match.Transplant is planned on 2nd July and We are going to admit on 21st June. Hoping this is a good match and also technology has been improved so much that MUD transplant gives same result as sibling. What are the chances of GVHD in such a good match? Is GVHD is visible in all transplant or only un some cases?
what is the difference in between 8/8 and 10/10 match?

[Neil Cuadra]

This is great news. I hope it goes very smoothly for your son.

Depending on which statistics you look at for which patient populations, you find that graft versus host disease affects less than half of patients. GVHD risk factors include higher age of the recipient, higher age of the donor, a male recipient with a female donor who has had children, and of course the degree of mismatch between donor and recipient. You are on the "good side" for most of these factors.

Unrelated donor transplants are more and more common because they have been more and more successful. They have always been the most successful for children. One reason that the overall statistics are hard to interpret is because of improved transplant success. If 100% of transplants were successful and without GVHD, they'd start doing transplants for higher-risk patients, which would help more people but bring the success rate down. That's what happens over time.

The most common types of GVHD affect the skin, the liver, or the digestive system. Even when it occurs, it can be mild and temporary.

An 8/8 match means that they matched the most important 8 antigens. Additional antigens may or may not match. With a 10/10 match they have confirmed the match for another pair of antigens. So an 8/8 match might actually be an 8/10 match or a 9/10 match or a 10/10 match. In some cases they test 12 antigens, not just 6, 8, or 10, but the additional matches are less and less important. Other factors, like the ones I mention above, can be statistically more important for success.

Good luck!

[pdiitdelhi0204]

Thanx sir.I know we have to be confident for good result in my case.In my son case Doctor didn't try for ATG. Ther are saying for child below 5 years, if you got 10/10 donor, it will be better to go directly for MUD transplant in stead of ATG. Also, today Doctor said donor is 49 year old male.

Originally Posted by Neil Cuadra

This is great news. I hope it goes very smoothly for your son.

Depending on which statistics you look at for which patient populations, you find that graft versus host disease affects less than half of patients. GVHD risk factors include higher age of the recipient, higher age of the donor, a male recipient with a female donor who has had children, and of course the degree of mismatch between donor and recipient. You are on the "good side" for most of these factors.

Unrelated donor transplants are more and more common because they have been more and more successful. They have always been the most successful for children. One reason that the overall statistics are hard to interpret is because of improved transplant success. If 100% of transplants were successful and without GVHD, they'd start doing transplants for higher-risk patients, which would help more people but bring the success rate down. That's what happens over time.

The most common types of GVHD affect the skin, the liver, or the digestive system. Even when it occurs, it can be mild and temporary.

An 8/8 match means that they matched the most important 8 antigens. Additional antigens may or may not match. With a 10/10 match they have confirmed the match for another pair of antigens. So an 8/8 match might actually be an 8/10 match or a 9/10 match or a 10/10 match. In some cases they test 12 antigens, not just 6, 8, or 10, but the additional matches are less and less important. Other factors, like the ones I mention above, can be statistically more important for success.

Good luck!

[Neil Cuadra]

Originally Posted by pdiitdelhi0204

Thanx sir.I know we have to be confident for good result in my case.In my son case Doctor didn't try for ATG. Ther are saying for child below 5 years, if you got 10/10 donor, it will be better to go directly for MUD transplant in stead of ATG. Also, today Doctor said donor is 49 year old male.

The timing is right. You'll be starting the transplant in a matter of days and all of these factors are in your favor, including having an experienced doctor who understands the treatment tradeoffs. I think that the parents who ask questions and learn what's going on are the parents who help their children the most.

Even though the doctor is directing the medical team, be sure to take advantage of the nurses and other professionals at the hospital, who can give you advice and assistance about your child's comfort, any day-to-day practical issues you have, and everything you'll need to know once your son goes home.