چكيده لاتين :
During the last two decades conventional therapy has improved
the prognosis of thalassemia. However, despite such improvement
it still remains a progressive disease with treatment-related
complications such as hepatitis, liver fibrosis, and cardiac disease.
Bone marrow transplantation (BMT) can prevent or delay
progression of the aforementioned complications. The importance
of clinical research in the field of BMT was recognized
with the award of the 1990 Nobel Prize in Physiology and
Medicine to E. Donnall Thomas, one of the pioneers of BMT in
humans. George Matheי was a pioneer in the early development
of clinical BMT. Matheי and co-workers were the first to describe
graft-versus-host-disease and its treatment, and the graftversus-
leukemia effect in human. The first BMT for beta-
thalassemia major was performed successfully by Thomas and
colleagues in Seattle, in 1981. In the same year another patient
with beta-thalassemia major underwent BMT in Pesaro, Italy, by
Lucarelli and others Since then, several hundred transplantations
have been performed worldwide, mostly in Italy. From 1991
through 2007 BMT have been performed on 497 (Tehran=342,
Shiraz=155) blood transfusion dependent patients with thalassemia
major in Iran, with disease-free survival of 71-77% respectively.
Because of high graft failure and high rates of graftversus-
host-disease rates, BMT from alternative donors should
be restricted to patients who have poor life expectancies because
they cannot receive adequate conventional treatment or because
of alloimmunization to minor blood antigens. Beginning in the
early 1980s, it was shown that umbilical cord blood contained
high levels of hematopoietic progenitor cells.
Iran J Med Sci 2009; 34(2): 81-93.
