title: Physicians' preferences and perceptions regarding donor selection in allogeneic stem cell transplantation in Korea when a matched domestic donor is not available.
abstract: BACKGROUND
  A number of alternative donor options exist for patients who fail to find domestic HLA-matched donors for allogeneic hematopoietic stem cell transplantation (allo-HSCT). We assessed physicians' perspectives on allo-HSCT donor selection when a matched domestic donor is not available.
  
  
  METHODS
  We administered a questionnaire survey to 55 hematologists (response rate: 28%) who attended the annual spring conference of the Korean Society of Haematology in 2015. The questionnaire contained four clinical allo-HSCT scenarios and the respondents were asked to choose the most preferred donor among the given options.
  
  
  RESULTS
  In all four scenarios, the hematologists preferred a matched international donor over partially mismatched unrelated domestic or haplo-matched family donors. The numbers of hematologists who chose a matched international donor (HLA 8/8) in cases of acute myeloid leukemia, chronic myeloid leukemia, acute lymphoblastic leukemia, and aplastic anemia were 37 (67.3%), 41 (74.6%), 33 (60.0%), and 36 (65.5%), respectively. The important factors that affected donor selection included "expecting better clinical outcomes (40.5%)" and "lower risk of side effects (23.4%)." The majority of participants (80%) responded that allo-HSCT guidelines for donor selection customized for the Korean setting are necessary.
  
  
  CONCLUSIONS
  Although hematologists still prefer perfectly matched foreign donors when a fully matched domestic allo-HSCT donor is not available, we confirmed that there was variation in their responses. For evidence-based clinical practice, it is necessary to provide further comparative clinical evidence on allo-HSCT from haplo-matched family donors and fully matched unrelated international donors.
authors.affiliation: National Evidence-based Healthcare Collaborating Agency, Seoul, Korea.
authors.forename: Min Kyung
authors.initials: MK
authors.lastname: Shin
authors.affiliation: National Evidence-based Healthcare Collaborating Agency, Seoul, Korea.
authors.forename: Sangjin
authors.initials: S
authors.lastname: Shin
authors.affiliation: National Evidence-based Healthcare Collaborating Agency, Seoul, Korea.
authors.forename: Ja Youn
authors.initials: JY
authors.lastname: Lee
authors.affiliation: National Evidence-based Healthcare Collaborating Agency, Seoul, Korea.; Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Youngil
authors.initials: Y
authors.lastname: Koh
keywords: Hematopoietic stem cell transplantation; Surveys and questionnaires; Unrelated donor