{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T09:37:43Z","timestamp":1792143463811,"version":"4.4.0"},"reference-count":51,"publisher":"American Society of Hematology","issue":"3","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,7,18]]},"abstract":"<jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>Selecting the most suitable alternative donor becomes challenging in severe aplastic anemia (SAA) when a matched sibling donor (MSD) is unavailable. We compared outcomes in patients with SAA undergoing stem cell transplantation (SCT) from matched unrelated donors (MUD) (n\u00a0= 1106), mismatched unrelated donors (MMUD) (n\u00a0= 340), and haploidentical donors (Haplo) (n\u00a0= 206) registered in the European Society for Blood and Marrow Transplantation database (2012-2021). For Haplo SCT, only those receiving posttransplant cyclophosphamide for graft-versus-host disease (GVHD) prophylaxis were included. Median age was 20 years, and the median time from diagnosis to transplantation 8.7 months. Compared with MUD, MMUD (hazard ratio [HR], 2.93; 95% confidence interval [CI], 1.52-5.6) and Haplo (HR, 5.15; 95% CI, 2.5-10.58) showed significantly higher risks of primary graft failure. MUD had lower rates of acute GVHD compared with MMUD and Haplo (grade 2-4: 13%, 22%, and 19%, respectively; P\u00a0&amp;lt; .001; grade 3-4: 5%, 9%, and 7%, respectively; P\u00a0= .028). The 3-year nonrelapse mortality rate was 14% for MUD, 19% for MMUD, and 27% for Haplo (P\u00a0&amp;lt; .001), whereas overall survival and GVHD and relapse-free survival (GRFS) rates were 81% and 73% for MUD, 74% and 65% for MMUD, and 63% and 54% for Haplo, respectively (P\u00a0&amp;lt; .001). In addition to donor type, multivariable analysis identified other factors associated with GRFS such as patient age, performance status, and interval between diagnosis and transplantation. For patients with SAA lacking an MSD, our findings support MUDs as the preferable alternative donor option. However, selecting between an MMUD and Haplo donor remains uncertain and requires further exploration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1182\/blood.2024024173","type":"journal-article","created":{"date-parts":[[2024,4,21]],"date-time":"2024-04-21T15:55:15Z","timestamp":1713714915000},"page":"323-333","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":33,"title":["Alternative donor transplantation for severe aplastic anemia: a comparative study of the SAAWP EBMT"],"prefix":"10.1182","volume":"144","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0024-8068","authenticated-orcid":false,"given":"Juan","family":"Montoro","sequence":"first","affiliation":[{"name":"1Department of Hematology, Hospital Universitario y Polit\u00e9cnico La Fe, Valencia, Valencia, Spain"},{"name":"2Universidad Cat\u00f3lica de Valencia, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk-Jan","family":"Eikema","sequence":"additional","affiliation":[{"name":"3EBMT Leiden Study Unit, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joe","family":"Tuffnell","sequence":"additional","affiliation":[{"name":"3EBMT Leiden Study Unit, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Potter","sequence":"additional","affiliation":[{"name":"4Department of Haematological Medicine, Kings College Hospital, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1174-5799","authenticated-orcid":false,"given":"Krzysztof","family":"Kalwak","sequence":"additional","affiliation":[{"name":"5Fundacja Na Ratunek Dzieciom z Choroba Nowotworowa, Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6573-0045","authenticated-orcid":false,"given":"Constantijn J. M.","family":"Halkes","sequence":"additional","affiliation":[{"name":"6Leiden University Hospital, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9589-4136","authenticated-orcid":false,"given":"Alexander","family":"Kulagin","sequence":"additional","affiliation":[{"name":"7RM Gorbacheva Research Institute, Pavlov University, St. Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6585-9586","authenticated-orcid":false,"given":"Matthew","family":"Collin","sequence":"additional","affiliation":[{"name":"8Northern Centre for Bone Marrow Transplantation, Newcastle, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert F.","family":"Wynn","sequence":"additional","affiliation":[{"name":"9Royal Manchester Children's Hospital, Manchester, United 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Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7092-3351","authenticated-orcid":false,"given":"Jakob","family":"Passweg","sequence":"additional","affiliation":[{"name":"16University Hospital Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8325-9215","authenticated-orcid":false,"given":"Stephan","family":"Mielke","sequence":"additional","affiliation":[{"name":"17Karolinska Institute and University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4431-643X","authenticated-orcid":false,"given":"Samppa","family":"Ryh\u00e4nen","sequence":"additional","affiliation":[{"name":"18Hospital for Children and Adolescent, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7914-0799","authenticated-orcid":false,"given":"Ben","family":"Carpenter","sequence":"additional","affiliation":[{"name":"19University College London Hospital, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3037-5378","authenticated-orcid":false,"given":"Tobias","family":"Gedde-Dahl","sequence":"additional","affiliation":[{"name":"20Oslo University Hospital, Rikshospitalet, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Tholouli","sequence":"additional","affiliation":[{"name":"21Manchester Royal Infirmary, Manchester, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renato","family":"Fanin","sequence":"additional","affiliation":[{"name":"22Azienda Ospedaliero Universitaria di Udine, Udine, 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