Dear Dr XXXXXXX Thanks For Your Earlier Reply In The

Question: Dear Dr XXXXXXX

Thanks for your earlier reply in the thread.-
https://www.healthcaremagic.com/AskDoctorInboxServlet?page=viewQuery&queryId=391903

You mentioned earlier that 9/10 match results are definitely not as good as 10/10 but still acceptable. Can you elaborate a bit? It means the higher failure rate, or more chance of severe GVHD or others?

You said that DRB1 mismatch is significant. Can you share your clinical experience of BMT with such mismatch or any research/studies on this ? For example, in terms of engraftment success, GVHD severity, etc.

You said that lot of transfusions definitely have negative impact on transplant outcome. Could you please elaborate a bit on the negative impacts? While there is no better option, we want to know how likely my niece’s heavy transfusion (about 300 bags of RBC and platelet in total so far) would affect the outcome, so that we could get more prepared psychologically.


For the induction regimen, doctor said my niece will receive chemo and radiotherapy. The dosage of radiotherapy is 1/6 of that for leukemia. (Dr. has not mentioned the dosage of chemo). With this dosage, what is the expected short term and long term discomforts/side effects?

We are worried that the donor may fail/refuse to donate in the last minute for some reasons. The donor will donate in the morning of the transplant day and the donated bone marrow will then be transported to our place on the same day by plane (donor is from overseas). There is also concern that the donated bone marrow may not be successfully delivered in time to our place. If such happen, my niece will be exposed to fatal risk? (because by that time she has already received chemo and radiotherapy already without immune functions). Anything can be done by the doctor to reduce the infection and death risk in such situations? Since my niece’s own immune system will have been destroyed by then but no new bone marrow coming in, does it mean that my niece will die soon? Any chance that she will recover her own immune system back to pre-induction situation? We are indeed very worried.

Grateful indeed if you could offer your views/advice and share your clinical experience as well. Thanks much

Thanks Dr fir your valuable advice.

Our doctor said the donated stem cells should be used within 3 days? You said can freeze it， does it mean that even we freeze it. it must be used within 3 days upon donation?

our doctor said my niece will start chemo on 30 Aug and also RT for two days, The induction regimen will end on 4 September. Donor will donate on 5 Sep and the donated stem cells will be delivered to our place by plane for transplant on the same day. If we freeze stem cells before induction regimen, the stem cells will be freezed for a week. Is this ok? Will this affect the transplant outcome or increase the risks?

Looking forward for your valuable advice. Thanks much

thanks Dr XXXXXXX for your prompt reply.

Do you know whether cryopreservation service / facilities for freezing stem cell usually available in transplant centres? Or is such facilities only available in large transplant centres?

Is it common to take this freezing option to avoid the fatal
consequence due to last minute mind change of donor or other reasons delaying the donation?

Our Dr has not mentioned this freezing option to us. As this is the one and only one BMT centre for adults in our place (Hong Kong). which is run and subsidised by the government, I worry that this cryopreservation service is not available, and we will face a big risk.
Because of the fatal consequence if donor changes mind last minute or stem cells not arrive in time, which might happen, we want to know more about what can be done and discuss with doctor our worries and any feasible options to address our worries.

Appreciate your views and advice.
Thanks!