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Chapter 10: Unrelated Donor HSCT 199 Table 1: Observations since the 2003 Edition • Transplantation using HLA-mismatched related or HLA-matched/mismatched unrelated donors should be performed at transplant centers that specialize in Fanconi anemia transplants and perform five or more such transplants a year. • Umbilical blood transplantation is an acceptable alternative, if HLA 8/8 matched marrow is not available. • Transplantation should be considered prior to the administration of blood products. Data document reduced survival after transplant in recipients of ≥20 blood product exposures. • Other risk factors adversely affecting survival after unrelated transplant potentially include HLA mismatch, prior exposure to androgens, and number of congenital malformations ≥3. • Fludarabine, in combination with cyclophosphamide and total body radiation, represents a new standard of care in the setting of unrelated HSCT. It is associated with an increased incidence of engraftment and survival in recipients of umbilical cord blood, peripheral blood stem cells or marrow and appears to reduce the deleterious effect of T-cell mosaicism.
200 Fanconi Anemia: Guidelines for Diagnosis and Management Table 2: Eligibility for Alternate Donor HSCT • Severe cytopenia (Hgb
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Chapter 4 Gastrointestinal, Hepatic
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Chapter 7 Endocrine Disorders in Fa
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Chapter 13 Head and Neck Squamous C
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Chapter 14 The Adult Fanconi Anemia
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