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Should a young matched unrelated donor be preferred over an older matched related donor in allogeneic stem cell transplantation for acute leukemia and myelodysplastic syndrome?

Bone Marrow Transplantation volume 60, pages 1062–1064 (2025)Cite this article

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To The Editor:

Whether young matched unrelated donors (MUD) or older matched related donors (MRD) should be preferred for allogeneic stem cell transplantation (allo-HSCT) is uncertain. Matched sibling donors (MSD) have traditionally been preferred over MUD due to lower risk of graft versus host-disease (GVHD) [1, 2] and better long-term survival. Additionally, MRD transplants offer more flexible scheduling and lower costs. However, after the implementation of high-resolution allele-level tissue typing and improved GVHD prophylaxis, outcome after MUD and MSD transplantation seem similar with respect to relapse-free and overall survival (OS) [3].

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Fig. 1: Outcomes for allogenic stem cell transplant with a young matched unrelated donor (MUD) age ≤25 years or an older matched related donor (MRD) aged ≥50 years.

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Authors and Affiliations

  1. Department of Haematology, Oslo University Hospital, Rikshospitalet, Oslo, Norway

    Birgitte S. Bergland, Mats Remberger, Geir Erland Tjønnfjord, Camilla Dao Vo, Anders E. Myhre, Ingerid W. Abrahamsen, Tobias Gedde-Dahl & Tor Henrik Anderson Tvedt

  2. Department of Medical Sciences, Uppsala University and KFUE, Uppsala University Hospital, Uppsala, Sweden

    Mats Remberger

  3. Institute of Clinical Medicine, University of Oslo, Oslo, Norway

    Geir Erland Tjønnfjord & Tobias Gedde-Dahl

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  1. Birgitte S. Bergland
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  2. Mats Remberger
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Contributions

THAT, BSB, TGD, and MR designed the study. MR performed the statistical analysis. BSB and THAT wrote the first draft of the manuscript. GET, CDV, AEM, and IWA provided critical review and edited the manuscript.

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Correspondence to Tor Henrik Anderson Tvedt.

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Bergland, B.S., Remberger, M., Tjønnfjord, G.E. et al. Should a young matched unrelated donor be preferred over an older matched related donor in allogeneic stem cell transplantation for acute leukemia and myelodysplastic syndrome?. Bone Marrow Transplant 60, 1062–1064 (2025). https://doi.org/10.1038/s41409-025-02579-1

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