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Who is the best alternative allotransplant donor?

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Abstract

Assuming that most physicians will chose an HLA-identical sibling as the best allotransplant donor, the question arises who is the best alternative donor when an HLA-identical sibling is unavailable? The most commonly used alternative donors are HLA-identical or -mismatched unrelated donors, HLA-matched or -mismatched umbilical cord blood donor or a related, HLA-haplotype-matched related donors. Each alternative donor option has advantages and disadvantages. We discuss selected aspects of these issues based on data from randomized clinical trials and observational databases. However, because there are limited data to address specific clinical settings, quantification of expert opinion is sometimes needed.

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Acknowledgements

Mary Horowitz kindly provided CIBMTR data. Yair Reisner kindly invited RPG to the HLA-Haplotype-Mismatched meeting. RPG acknowledges support from the NIHR Biomedical Research Centre funding scheme.

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Authors and Affiliations

  1. Department of Medicine, Division of Experimental Medicine, Haematology Centre, Imperial College London, London, UK

    R P Gale

  2. Center for International Blood and Marrow Research, Medical College of Wisconsin, Milwaukee, WI, USA

    M Eapen

Authors
  1. R P Gale
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  2. M Eapen
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Correspondence to R P Gale.

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The authors declare no conflict of interest.

Additional information

This article was published as part of a supplement, supported by WIS-CSP Foundation, in collaboration with Gilead, Milteny Biotec, Gamida Cell, Adienne Pharma and Biotech, Medac Hematology, Kiadis Pharma and Almog Diagnostic.

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Gale, R., Eapen, M. Who is the best alternative allotransplant donor?. Bone Marrow Transplant 50 (Suppl 2), S40–S42 (2015). https://doi.org/10.1038/bmt.2015.94

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