This review discusses selecting among unrelated, cord blood, and haploidentical grafts for patients with Ph-negative ALL in CR1 when an HLA-matched related donor is unavailable. The authors review research showing that HLA-matched unrelated donor HCT can result in survival comparable to related donor HCT, with four-year survival of 62% and 65%, respectively. Four-year survival of 57% can be achieved in unrelated cord blood transplantation. According to the authors, this therapy is also appropriate, especially for young patients without an HLA-matched unrelated donor or those in urgent need of HCT. They recommend that haploidentical donor HCT is best reserved for patients achieving CR, who can have three-year survival of up to 65%, but only 5-7% in non-CR.
Nishiwaki S, et al. Bone Marrow Transplant
Review: Comparing HCT Donor Options in Ph- ALL
Nov 2013