The purpose of this study was to compare transplantation outcomes in @entity1 with @entity1583 who received marrow grafts from either phenotypically matched unrelated, one-antigen-mismatched unrelated, or highly human leukocyte antigen (HLA)-disparate family donors. Between 1993 and 2000, 139 @entity1 underwent transplantation from unrelated donors (81 matched and 58 mismatched) and 48 @entity1 received marrow grafts from family donors that were mismatched at 2, 3, or 4 of 8 HLA loci. All @entity1 received a standardized conditioning regimen and a @entity2132 ( @entity2132 ) prophylaxis schedule with the exception of recipients of haploidentical marrow grafts, who received antithymocyte globulin after bone marrow transplantation as additional immunosuppression. There was no statistically significant difference in the rate of engraftment, or the cumulative incidences of acute and chronic @entity2132 between any of the 3 groups. The 2-year cumulative incidence of relapse was lower in matched unrelated @entity1 (25%, P =.01) and mismatched unrelated @entity1 (26%, P =.014) than in haploidentical @entity1 (42%). Transplant-related mortality was significantly higher in recipients of mismatched unrelated grafts (45%, P =.01) and haploidentical grafts (42%, P =.001) compared with recipients of matched unrelated marrow grafts (23%). This resulted in a significantly higher probability of overall survival for matched unrelated @entity1 (58%) versus either mismatched unrelated (34%, P =.01) or haploidentical (21%, P =.002) @entity1 . There was no statistically significant difference in survival between @entity1 who received mismatched unrelated grafts versus those who received haploidentical grafts. This study supports a donor selection algorithm whereby @entity1 who lack a closely matched family donor be offered a phenotypically matched unrelated donor if available. There is no apparent advantage to using a mismatched unrelated versus a highly HLA-disparate family donor.

Superior survival associated with transplantation of matched unrelated versus one-antigen-mismatched unrelated or highly human leukocyte antigen-disparate haploidentical family donor marrow grafts for the treatment of XXXX : establishing a treatment algorithm for recipients of alternative donor grafts.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity2132 :: ('MESH:D006086', 'Disease') :: ['graft-versus-host disease', 'GVHD'] @entity1583 :: ('MESH:D019337', 'Disease') :: ['hematologic malignancies']
@entity1583 :: (MESH:D019337,Disease) :: ['hematologic malignancies']
