Bone Marrow Transplantation in the Treatment of Severe Immunodeficiencies: Possibilities and Problems

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Abstract
Infants and children suffering from severe primary immunodol idiondies may be cured by bone marrow transplantation from a healthy donor. Data obtained in 14 European centers show that about 60% of the patients are surviving disease-free, if they were grafted with bone marrow cells from an ELA-identical related donor. Results of transplantation of T-cell depleted bone marrow from an HLA-haloidentical related donor were also excellent in infants with severe combined immunodeficiency, with 60% recovery. This therapy is superior to transplantation of fetal tissues. HLA-haploidentical T-cell depleted maroow transplantation for other severe immunodeficiencies was less successful. This was mainly due to failure of engraftment, despite intensive conditioning of the recipient, and to infectious complications e. g. by reactivation of latently present viruses.