Table 3.

Donor selection considerations and order of preference

Ideal Donor		8/8 HLA matched sibling donor	High (best) overall survival No need for TBI Excellent engraftment Minimal rates of GVHD with TCD Related donor less expensive to acquire
Alternative Donors	Excellent	8/8 HLA matched non-genotypic related donor 7/8 HLA matched sibling/related donor 8/8 HLA matched unrelated donor	Results similar between the 3 sources High overall survival Benefit from low dose TBI Excellent engraftment Low rates of GVHD with TCD Related donor less expensive to acquire
	Good	5–6/6 HLA matched unrelated UCB donor	Good overall survival Good engraftment Minimal GVHD
	Less Suitable	7/8 HLA matched unrelated donor 4/6 HLA matched unrelated UCB donor	Adequate overall survival Less reliable engraftment Moderate rates of GVHD Equivalent expense to acquire HSCs Selection based on urgency and institutional preference
Investigational Donor		Haploidentical related donor	Use based on institutional preference Consider alternatives such as androgens to delay transplant

HLA, human leukocyte antigen; TBI, total body irradiation; GVHD, graft-versus-host disease; TCD, T cell depletion; UCB, umbilical cord blood