Table 1.

Haplo-SCT vs CBT: advantages and disadvantages

DonorCBTHAPLO-transplant
SCBTDCBTTCDTCR
Indications Nonmalignant and malignant Nonmalignant and malignant Mainly malignant Mainly malignant 
Age Mainly pediatric Adult and pediatric Adult and pediatric Adult and pediatric 
Donor availability High High High High 
Degree of HLA mismatch 1-2 mismatches 1-2 mismatches 2-3 mismatches 2-3 mismatches 
DSA Important Important Important Important 
Time for donor identification Slower
<1 month 
Slower compared to SCBT Faster (immediate) Faster (immediate) 
Time of graft acquisition 15-30 days 15-30 days 15-30 days 15-30 days 
Type of graft Cryopreserved CBU 2 cryopreserved CBUs Mobilized PB Mobilized PB and/or BM 
Limitation of graft acquisition Cell dose Improved compared to SCBT Poor mobilization Improved compared to TCD haplo 
Graft manipulation Ex vivo expansion None In vivo TCD None 
Donor safety (risk to the donor) No risk No risk Very low Very low 
Easy to repeat stem cell donation Not possible Not possible Possible Possible 
Conditioning MAC and RIC MAC and RIC MAC MAC and RIC 
Engraftment Delayed Improvement compared to SCBT Comparable to MRD or MUD Comparable to MRD or MUD 
Use of ATG Determinantal omitted Determinantal omitted Indicated (can be replaced by PTCy) Indicated (can be replaced by PTCy) 
GVHD Lower incidence with less stringent HLA matching needed Incidence increased compared to SCBT Low incidence Low incidence with BM and PTCy; higher incidence with PB 
NRM High due to graft failure and infections Improved compared to SCBT High Improved compared to TCD-haplo 
RI Comparable to MSD or MUD Low compared to SCBT High Comparable to MSD or MUD (higher in initial report) with BM and RIC 
DLI Not possible Not possible Possible Possible 
Immune reconstitution Slow Improved compared to SCBT Slow Improved compared to TCD-haplo 
Infections incidence High Improved compared to SCBT High Improved compared to TCD-Haplo 
OS Lower than other stem cell sources Improved compared to SCBT Lower than other stem cell sources Improved compared to TCD-Haplo 
Cost associated with donor search and graft procurement High Very high Lower Lower 
DonorCBTHAPLO-transplant
SCBTDCBTTCDTCR
Indications Nonmalignant and malignant Nonmalignant and malignant Mainly malignant Mainly malignant 
Age Mainly pediatric Adult and pediatric Adult and pediatric Adult and pediatric 
Donor availability High High High High 
Degree of HLA mismatch 1-2 mismatches 1-2 mismatches 2-3 mismatches 2-3 mismatches 
DSA Important Important Important Important 
Time for donor identification Slower
<1 month 
Slower compared to SCBT Faster (immediate) Faster (immediate) 
Time of graft acquisition 15-30 days 15-30 days 15-30 days 15-30 days 
Type of graft Cryopreserved CBU 2 cryopreserved CBUs Mobilized PB Mobilized PB and/or BM 
Limitation of graft acquisition Cell dose Improved compared to SCBT Poor mobilization Improved compared to TCD haplo 
Graft manipulation Ex vivo expansion None In vivo TCD None 
Donor safety (risk to the donor) No risk No risk Very low Very low 
Easy to repeat stem cell donation Not possible Not possible Possible Possible 
Conditioning MAC and RIC MAC and RIC MAC MAC and RIC 
Engraftment Delayed Improvement compared to SCBT Comparable to MRD or MUD Comparable to MRD or MUD 
Use of ATG Determinantal omitted Determinantal omitted Indicated (can be replaced by PTCy) Indicated (can be replaced by PTCy) 
GVHD Lower incidence with less stringent HLA matching needed Incidence increased compared to SCBT Low incidence Low incidence with BM and PTCy; higher incidence with PB 
NRM High due to graft failure and infections Improved compared to SCBT High Improved compared to TCD-haplo 
RI Comparable to MSD or MUD Low compared to SCBT High Comparable to MSD or MUD (higher in initial report) with BM and RIC 
DLI Not possible Not possible Possible Possible 
Immune reconstitution Slow Improved compared to SCBT Slow Improved compared to TCD-haplo 
Infections incidence High Improved compared to SCBT High Improved compared to TCD-Haplo 
OS Lower than other stem cell sources Improved compared to SCBT Lower than other stem cell sources Improved compared to TCD-Haplo 
Cost associated with donor search and graft procurement High Very high Lower Lower 

SCBT, single cord blood transplantation; TCD, T-cell depletion; TCR, T-cell repletion.

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