Description
Allogeneic Stem Cell Transplant Donor Sources
Stem cell donor source: donor cells are matched to pt by HLA typing to minimize GVHD; matching at alleles A, B, C, DR, DQ
• Matched-related donor (MRD): preferred, compatible siblings, matched at 10/10 HLA alleles
• Matched-unrelated donor (MUD): common, NMDP database, matched at 8-9/10 HLA alleles
• Haploidentical: any parent/sibling/child is a match, match 5/10 HLA alleles, ↑GVHD; post-SCT cyclophosphamide (PTCy) removes alloreactive donor T-cells, reduces GVHD
• Stem cell collection: MRD, MUD, haploidentical stem cells can be collected via peripheral blood or direct from bone marrow; PBSC has more GVHD but less graft failure, BM has less GVHD but higher graft failure
• Umbilical Cord Blood (UCB): immature SC from fetus – allows for more HLA disparity and quick to obtain, but delayed engraftment and ↑txp-mortality compared to MUD (similar DFS/OS, ↓severe GVHD)
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