title: Alternative Donor Allogeneic Hematopoietic Cell Transplantation for Acute Myeloid Leukemia.
abstract: Allogeneic hematopoietic cell transplantation (alloHCT) provides a potentially curative therapy for patients with high-risk or chemorefractory acute myeloid leukemia (AML). Historically, the applicability of alloHCT has been limited as only 30%-35% of patients have human leukocyte antigen (HLA)-matched siblings and outcomes using other donor types have been markedly inferior due to excess toxicity, graft failure, graft-versus-host disease (GVHD), and consequently non-relapse mortality. Advances in HLA typing, GVHD prophylactic approaches, and other transplantation techniques have successfully addressed these historical challenges. Herein, we review recent alloHCT studies using volunteer unrelated donors, umbilical cord blood units, or HLA-haploidentical donors, specifically focusing on studies that compared outcomes between donor sources. Although none are randomized and most are retrospective, these analyses suggest that current outcomes for AML patients using most alternative donor types are comparable to those seen using HLA-matched siblings.
authors.affiliation: Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD. Electronic address: christopher.kanakry@nih.gov.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Kanakry
authors.affiliation: University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH.
authors.forename: Marcos J
authors.initials: MJ
authors.lastname: de Lima
authors.affiliation: Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Leo
authors.initials: L
authors.lastname: Luznik
mesh_terms: D006086:Graft vs Host Disease / Q000209:etiology; D006238:Haploidy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006650:Histocompatibility Testing; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D014019:Tissue Donors; D014184:Transplantation, Homologous