Using a case study of a patient with de novo AML lacking a matched related or unrelated donor, the authors evaluate published current and relevant data on choosing between an umbilical cord blood (UCB) transplant and a haploidentical transplant for this patient. The authors conclude that their review of published data support the use of any of the following donor options for the patient in this case study: haploidentical relative, HLA-mismatched unrelated adult, or UCB. They further recommend enrolling the patient in the clinical trial (BMT CTN 1101) that randomizes patients to receive bone marrow grafts from a haploidentical relative or two UCB units. They note that optimal timing is critical to successful HCT outcomes and an early donor search should be initiated in a timely manner. A detailed donor selection algorithm is presented to guide the clinical decision-making process for patients lacking HLA-matched related or unrelated donors.
Eapen M, et al. Biol Blood Marrow Transplant