Alternative transplant donor sources: Is there any consensus?

Ephraim Fuchs, Paul V. O'Donnell, Claudio G. Brunstein

Research output: Contribution to journalReview articlepeer-review

14 Scopus citations


Purpose of Review: To review the data supporting the use of alternative donors for hematopoietic cell transplantation of patients with high-risk or advanced hematological malignancies. Recent Findings: Advances in supportive therapy and technology have improved the safety and efficacy of alternative donors for hematopoietic cell transplantation. Molecular techniques have allowed for better human leukocyte antigen matching of unrelated adult donors. Novel strategies such as adoptive regulatory T cells or posttransplantation cyclophosphamide contributed to better outcomes after partially matched related donors. In umbilical cord blood transplantation, the ability to find adequately dosed single-unit grafts, the utilization of double-unit grafts, and novel methodologies such as ex-vivo expansion, intrabone injection, and priming to accelerate engraftment are promising. Available retrospective studies suggest despite the differences in hematopoietic recovery, risk of graft-versus-host disease, and relapse, long-term outcomes are similar between different alternative donor types. Summary: In the absence of a suitable matched related donor, most patients will be able to find an alternative donor to proceed to a potentially curative allogeneic transplantation. Emerging new technologies will further improve the safety and efficacy of alternative donor transplantation. Ongoing and future randomized studies will better define the relative efficacy of alternative donor types.

Original languageEnglish (US)
Pages (from-to)173-179
Number of pages7
JournalCurrent Opinion in Oncology
Issue number2
StatePublished - Mar 2013


  • allogeneic transplantation
  • alternative donors
  • partially matched related donors
  • umbilical cord blood
  • unrelated adult donors


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