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New technique reduces bone marrow transplant risks in children

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Children needing chemotherapy to prepare them for bone marrow transplants can now be treated with a new technique designed to prevent rejection of transplant cells and avoid more severe side effects.

Doctors at Great Ormond Street Hospital (GOSH) and the UCL Institute of Child Health have developed a method to create space for donor cells using antibodies which recognise and kill the patient’s own bone marrow.

Also reducing the risk of rejection by the body, the technique uses an antibody directed against a molecule called CD45, to wipe out patients’ own diseased bone marrow tissue and create a space for the healthy bone marrow from the donor to grow. The study has been published in the Lancet.

The technique was successfully used in children with genetic defects of their immune systems (primary immunodeficiencies or PID) who were too ill for a traditional bone marrow transplant and would have needed high doses of chemotherapy to destroy their own bone marrow tissue first.

Without a bone marrow transplant, children with PID often die from infection and other complications.

Dr Persis Amrolia, a consultant in bone marrow transplant at GOSH who led the research, described the results as “remarkable”.

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