title: Alternative donor transplantation for adults with acute leukemia.
abstract: Allogeneic hematopoietic cell transplantation (HCT) from a matched related donor (MRD) is the preferred therapy for many adults with acute leukemia. Yet most patients do not have matched siblings, and the numbers who do will continue to drop as the average number of children per couple in the United States continues to decline. Recent reports show little difference in the outcomes of matched related and matched unrelated transplants for acute leukemia. Additionally, survival rates at 3-5 years after transplant appear to be generally similar following matched related, matched unrelated, single antigen mismatched unrelated, double cord blood and, perhaps even after haplo-identical transplants. Nevertheless, there are differences between stem cell sources that should be considered in the choice of donor. The following review provides some perspective on the identification of the best stem cell sources for patients who do not have matches within their families.
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, USA; Division of Medical Oncology, University of Washington School of Medicine, USA. Electronic address: fappelba@fhcrc.org.
authors.forename: Frederick R
authors.initials: FR
authors.lastname: Appelbaum
mesh_terms: D000208:Acute Disease; D000328:Adult; D064591:Allografts; D018572:Disease-Free Survival; D046148:Donor Selection / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007938:Leukemia / Q000401:mortality* / Q000628:therapy*; D019520:Living Donors; D015996:Survival Rate; D061349:Unrelated Donors
keywords: acute lymphoblastic leukemia; acute myeloid leukemia; graft versus host disease; hematopoietic cell transplantation; matched related donor; matched unrelated donor; mismatched unrelated donor; umbilical cord blood