To the Editor: As emphasized by Dr Koreth and colleagues,1 the assessment of allogeneic stem cell transplantation for acute myeloid leukemia in first complete remission requires controlled prospective clinical trials. In their meta-analysis, the authors evaluated trials in which treatment assignment was based on the presence or absence of an HLA-matched donor. Although the authors recognized the inclusion of patients having no siblings as a source of bias,2 they did not select their group for analysis accordingly.
Of the patients in their meta-analysis, 91% were from published trials of donor vs no-donor analyses, in which patients without siblings were included in the no-donor group. Reliable data on the relative value of allogeneic stem cell transplantation for acute myeloid leukemia in the past requires re-evaluation of donor vs no-donor comparisons focused on documented tissue-typed patients and their siblings.
Concerns about the equivalence of related and unrelated donors should no longer be a problem in contemporary evaluation of allogeneic transplantations. Because unrelated donors have become widely available, it is now feasible for the role of allogeneic stem cell transplantation to be assessed through randomized assignment for this option.
Financial Disclosures: None reported.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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