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

다국어 초록 (Multilingual 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 do-mestic 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 parti-ally 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 mye-loid leukemia, chronic myeloid leukemia, acute lymphoblastic leukemia, and aplastic ane-mia 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%) re-sponded 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 match-ed 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.