Which donor is best for transplant when a matched donor is not available?

This study aimed to investigate which type of donor is best for allogeneic stem cell transplant when a sibling matched donor is not available. This study concluded that both haploidentical (matched but not identical) and international donors can be used for allogeneic stem cell transplant when a sibling matched donor is not available.

Allogeneic stem cell transplantation (alloSCT) involves collecting stem cells from a matching donor and transplanting into the patient to restore the cells that have been damaged in cancer. It is a method commonly used in leukemia patients. Stem cells can come from a variety of sources but the most ideal donor is a human leukocyte antigen (HLA)-matched sibling donor. HLA are markers found on cells.

Some patients requiring alloSCT do not have a HLA-matched sibling donor. It was not known which other donor type is better when the HLA-matched sibling donor is not available.

This study involved 176 patients with myelodysplastic syndrome and acute leukemia. 121 patients underwent alloSCT from haploidentical (matched but not related) donors. 55 patients underwent alloSCT from international (not matched and not related) donors.

The 2-year overall survival rate was 33.4% for the haploidentical group compared to 35.3% for the international group.The relapse free survival rate was 31.7% for the haploidentical group compared to 34.4% for the international group.

There were no significant differences in incidences of acute and chronic graft versus host disease (GVHD, when the transplanted cells attack healthy tissue) between the two groups.

There were no significant differences between the incidence of infection within 30 days between the two groups.

This study concluded that both haploidentical and international donors can be used for alloSCT when a sibling matched donor is not available.

A larger study needs to be carried out.

Consult your physician about the best donor option for alloSCT.