Use of alternative donor sources is growing: Advances in graft-versus-host disease (GVHD) prophylaxis, including use of post-transplant cyclophosphamide, have made HCT a viable treatment option for more patients unlikely to have a matched donor. However, more guidance on donor search strategy and selection is needed to help these patients achieve HCT in a timely manner to improve outcomes.
Similar time to transplant for those unlikely to have a full 8/8 match: Results from the BMT CTN 1702 study show that with an early alternative-donor-centered search strategy, patients with poor likelihood of finding a matched unrelated donor (MUD) still achieve transplant at comparable rates and without added resource utilization or delays in care.
Identifying and prioritizing donor sources early can impact outcomes: Since patients who get HCT earlier in their disease course have better survival, it’s critical to understand early on if a donor search should focus on finding alternative donor sources. This strategy can be particularly beneficial for patients who are racially and ethnically diverse who are less likely to have full matches on global donor registries, helping to reduce outcome disparities for these groups.
Time to transplant largely depends on patient factors: Achieving target HCT timing was more often delayed due to a patient’s disease course and not due to donor availability when a strategic donor search was conducted. Having multiple donor options can help stick to desired timelines in case of complications with a patient’s clinical pathway.
Physician perceptions about donor availability impact access: While this trial adds to the mounting evidence that there is a donor for all, there is still work to be done to level the playing field for all patients. Experts urge that the perception that some patients do not have a suitable donor should not deter hematologists/oncologists from referring for an early consult.