Published online Sep 26, 2014. doi: 10.4252/wjsc.v6.i4.371
Revised: June 12, 2014
Accepted: July 17, 2014
Published online: September 26, 2014
Hematopoeitic cell transplantation is established as a curative treatment for patients w acute myelogenous leukemia. Haploidentical family donor and umbilical cord blood (UCB) are alternative sources of stem cells for patients lacking a matched sibling or unrelated donor. The early challenges of transplant complications related to poor engraftment and graft-vs-host disease have been overcome with new strategies such as using 2 units and increased cell dose in UCB and T-cell depletion and post transplantation cyclophosphamide in haploidentical transplantation. The outcomes of alternative transplantation for acute leukemia were compared to other traditional graft sources. For patients lacking a matched sibling or unrelated donor, either strategy is a suitable option. The choice should rely mostly on the urgency of the transplantation and the available cell dose as well as the expertise available at the transplant center. This manuscript reviews the options of alternative donor transplantation and highlights recent advances in each of these promising transplantation options.
Core tip: Allogeneic hematopoeitic cell transplantation is a curative treatment for patients with acute leuekemia. Many patients lack a suitable matched donor and require another stem cell source. The choice between cord blood and mismatched relative is challenging as there is no direct comparison between the two transplantation modalities. This manuscript highlights the studies and current innovative approaches with either modality with an emphasis on the recent studies aiming at decreasing complications, enhancing engraftment and speeding immune recovery.