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F. Bernaudin et al.
Furthermore, this study does not allow the chances of fer- tility after ovarian or testicular reimplantation to be esti- mated. However, the present study is the first to report the very long-term outcome in patients with mixed chimerism and to show that the correction of hemolytic anemia requires a higher donor cell% than the prevention of SCA-related crises.
The issue now is to determine whether a protocol offer- ing an EFS at 87% with no TRM and no GvHD should also be favored for children. In France, the myeloablative CR with 98% EFS with a very low risk of cGvHD is still currently used in children under 15 years of age, but we recommend the NIH protocol for patients older than 15.
However, we recognize that this is still a matter of debate and additional prospective studies may result in a change in course depending on the long-term results of MSD-SCT with non-myeloablative CR.
Acknowledgments
The authors would like to thank all the patients and their fam- ilies for their participation in this study, all the nurses on the var- ious transplantation units and outpatient clinics for their dedicat- ed work and the doctors who referred patients for transplantation. We also thank Dr. Martine Torres for her critical reading and editing of the manuscript which was supported through an unre- stricted grant from bluebird bio.
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