Does matched unrelated donor transplantation have the same outcome as matched sibling transplantation in unselected patients?

Best Pract Res Clin Haematol. 2012 Dec;25(4):483-6. doi: 10.1016/j.beha.2012.10.012. Epub 2012 Nov 20.

Abstract

Outcome differences by donor type for allogeneic hematopoietic stem cell transplantation vary based on disease and recipient age. The following paper summarizes analyses of transplant outcome among adults with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) who received transplants from HLA-identical siblings, fully (8/8) matched unrelated donors (MUD), or mismatched (7/8) unrelated donors. The paper also reviews transplantation outcomes for children with leukemia who had genotypically matched sibling donors, mismatched (7/8) or phenotypically matched related donors or matched (8/8) unrelated donors. Morbidity is higher after unrelated donor vs HLA-matched sibling transplants due to higher rates of acute graft-vs-host disease (GVHD). However, survival is similar or within 10%-15% with all studies donor type, with disease-specific differences probably reflecting differences in underlying population risk for treatment-related mortality.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Adult
  • Child
  • Child, Preschool
  • Disease-Free Survival
  • Donor Selection*
  • Female
  • Graft vs Host Disease / mortality
  • Graft vs Host Disease / therapy
  • Hematopoietic Stem Cell Transplantation*
  • Histocompatibility Testing
  • Humans
  • Infant
  • Leukemia, Myeloid, Acute* / mortality
  • Leukemia, Myeloid, Acute* / therapy
  • Male
  • Myelodysplastic Syndromes* / mortality
  • Myelodysplastic Syndromes* / therapy
  • Risk Factors
  • Siblings
  • Survival Rate
  • Transplantation, Homologous