同种异体造血细胞移植（HCT）可能为仅靠化疗不太可能治愈的急性髓系白血病（AML）患者提供治愈方法。此前，仅使用人类白细胞抗原（HLA）匹配的相关供体，这使得该手术适用于有限比例的患者。高分辨率HLA分型技术的引入、免疫抑制治疗的创新以及改进的支持性护理措施显着改变了这种情况。现在，没有匹配的相关供体的患者有充分的机会通过使用匹配或不匹配的无关供体、脐带血移植物或半相合相关供体来接受同种异体 HCT。过去几十年来，替代供体移植的结果有所改善，无关供体登记的增长以及供体多样化增加了找到合适供体的机会。由于大多数患者有多种可供选择的供体选择，供体选择变得越来越重要。为了讨论在无法获得 HLA 匹配的相关供体的情况下的最佳供体选择，本文回顾了 AML 中不同替代供体移植的回顾性和前瞻性比较的现有文献，并讨论了同种异体 HCT 中当前最先进的模式另类捐赠者。© 2024。作者获得 Springer-Verlag GmbH 德国（Springer Nature 旗下公司）的独家许可。

Allogeneic hematopoietic cell transplantation (HCT) potentially provides a cure for patients with acute myeloid leukemia (AML) who are unlikely to be cured with chemotherapy alone. Previously, human leukocyte antigen (HLA)-matched related donors were used exclusively, which made the procedure available for a limited proportion of patients. The introduction of high-resolution HLA-typing technology, innovations in immunosuppressive therapy, and improved supportive care measures have significantly changed the situation. Now, patients without a matched related donor have an ample opportunity to receive allogeneic HCT with the use of matched or mismatched unrelated donors, umbilical cord blood grafts, or haploidentical related donors. The outcomes of alternative donor transplantations have improved over the past decades, and the growth of unrelated donor registries as well as the donor diversification have enhanced the chance of finding a suitable donor. With multiple alternative donor choices available for most patients, the donor selection is becoming increasingly important. To discuss the optimal donor choice in case of unavailability of an HLA-matched related donor, this article reviews the existing literature of retrospective and prospective comparisons of different alternative donor transplantations in AML and discusses the current state-of-art modalities in allogeneic HCT using alternative donors.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.