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We conducted a nationwide retrospective study to examine the prognostic impact of donor sources based on transplantation application timings: human leukocyte antigen (HLA)\u2010matched related donor (MRD;\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a0253), unrelated donor (URD;\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a0656), unrelated cord blood (U\u2010CB;\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a0599), and HLA\u2010haploidentical related donor with post\u2010transplant cyclophosphamide (PT\u2010CY;\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a0166). In patients with the early application of allo\u2010HSCT (&lt; 100\u00a0days from diagnosis), the multivariate analysis showed no significant difference in overall mortality (OM) among all donor sources. Regarding the middle timing of allo\u2010HSCT (100\u2013179\u00a0days), the U\u2010CB group showed higher OM than the MRD group (hazard ratio [HR], 1.37;\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a00.013), while the URD and PT\u2010CY groups showed no significant difference in OM with the MRD group. Concerning the late timing of allo\u2010HSCT (180\u2013270\u00a0days), the U\u2010CB (HR, 1.88;\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a00.005) and PT\u2010CY groups (HR, 1.90;\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a00.043) showed higher OM than the MRD group, whereas the URD group exhibited comparable OM to the MRD group. The present study demonstrated the differential impact of the graft source based on the timing of allo\u2010HSCT for ATL; therefore, it is important to select an optimal alternative donor based on application timing.\n                  <\/jats:p>","DOI":"10.1002\/hon.70220","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T12:37:51Z","timestamp":1784032671000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Application Timing\u2010Dependent Impact of Donor Source on Outcomes After Allogeneic Hematopoietic Stem Cell Transplantation for Adult T\u2010Cell Leukemia\/Lymphoma"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1438-3623","authenticated-orcid":false,"given":"Hidehiro","family":"Itonaga","sequence":"first","affiliation":[{"name":"Transfusion and Cell Therapy Unit Nagasaki University Hospital  Nagasaki 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