So far we have carried out HSCT in 48 patients aged 55.3 to 66.2 years. The patients were conditioned either with cyclophosphamide plus TBI, or busulfan plus TBI, or busulfan plus cyclophos-phamide. Seven patients died early from disease or from treatment-related complications. These results clearly show that MDS patients in their seventh decade of life can be transplanted successfully. GvHD weakens the patient's immune system and requires treatment with immunosuppressive drugs.
All patients are at high risk of severe infection for months or even years after transplantation.
Some infections, particularly with fungal organisms, can prove fatal. Transplants from Unrelated Donors As mentioned, for many patients an unrelated volunteer donor matched for HLA can be identified in the established registries. In early trials transplants from unrelated donors led to severe complications, presumably because of genetic differences between patient and donor. With better tissue-typing techniques developed in recent years, transplant results have improved substantially. For patients up to 55 years of age with RA, we used a regimen combining busulfan and cyclophos-phamide in preparation for transplantation from an unrelated donor.