Blood Res.  2017 Mar;52(1):31-36. 10.5045/br.2017.52.1.31.

Physicians' preferences and perceptions regarding donor selection in allogeneic stem cell transplantation in Korea when a matched domestic donor is not available

• Shin MK
• Shin S
• Lee JY
• Koh Y

• KMID: 2375201
• DOI: http://doi.org/10.5045/br.2017.52.1.31

Abstract

BACKGROUND
A number of alternative donor options exist for patients who fail to find domestic HLA-matched donors for allogeneic hematopoietic stem cell transplantation (allo-HSCT). We assessed physicians' perspectives on allo-HSCT donor selection when a matched domestic donor is not available.
METHODS
We administered a questionnaire survey to 55 hematologists (response rate: 28%) who attended the annual spring conference of the Korean Society of Haematology in 2015. The questionnaire contained four clinical allo-HSCT scenarios and the respondents were asked to choose the most preferred donor among the given options.
RESULTS
In all four scenarios, the hematologists preferred a matched international donor over partially mismatched unrelated domestic or haplo-matched family donors. The numbers of hematologists who chose a matched international donor (HLA 8/8) in cases of acute myeloid leukemia, chronic myeloid leukemia, acute lymphoblastic leukemia, and aplastic anemia were 37 (67.3%), 41 (74.6%), 33 (60.0%), and 36 (65.5%), respectively. The important factors that affected donor selection included "expecting better clinical outcomes (40.5%)" and "lower risk of side effects (23.4%)." The majority of participants (80%) responded that allo-HSCT guidelines for donor selection customized for the Korean setting are necessary.
CONCLUSION
Although hematologists still prefer perfectly matched foreign donors when a fully matched domestic allo-HSCT donor is not available, we confirmed that there was variation in their responses. For evidence-based clinical practice, it is necessary to provide further comparative clinical evidence on allo-HSCT from haplo-matched family donors and fully matched unrelated international donors.

Keyword

Hematopoietic stem cell transplantation; Unrelated donor; Surveys and questionnaires

MeSH Terms

Anemia, Aplastic
Donor Selection*
Hematopoietic Stem Cell Transplantation
Humans
Korea*
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Leukemia, Myeloid, Acute
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Stem Cell Transplantation*
Stem Cells*
Surveys and Questionnaires
Tissue Donors*
Unrelated Donors

Figure

• 

  Fig. 1 Results of donor selection by case scenario. (A) Acute myeloid leukemia (AML), (B) Chronic myeloid leukemia (CML), (C) Acute lymphoblastic leukemia (ALL), (D) Aplastic anemia (AA).

• 

  Fig. 2 Reference for donor selection. Multiple choices were not allowed, but two respondents mistakenly gave multiple responses.

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