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. 2017 Mar;52(1):31-36.
doi: 10.5045/br.2017.52.1.31. Epub 2017 Mar 27.

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

Min Kyung Shin  1 , Sangjin Shin  1 , Ja Youn Lee  1 , Youngil Koh  2
Affiliations

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

Min Kyung Shin et al. Blood Res. 2017 Mar.

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.

Keywords: Hematopoietic stem cell transplantation; Surveys and questionnaires; Unrelated donor.

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Conflict of interest statement

Authors' Disclosures of Potential Conflicts of Interest: No potential conflicts of interest relevant to this article were reported.

Figures

Fig. 1
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
Fig. 2. Reference for donor selection. Multiple choices were not allowed, but two respondents mistakenly gave multiple responses.
See this image and copyright information in PMC

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