Fanconi anemia strikes early in utero.

loidentical transplantation. Whether there is greater dependence on an early T-cell response or another mechanism, the data suggest that T cell– depleted haploidentical transplantation should be used only for children with ALL at CR2 or higher, no matter the center size. In summary, this study suggests that for the majority of pediatric HCT centers, UCB transplantation should be the preferred option. T cell– depleted haploidentical transplantation should be used only for children with ALL at CR2 or higher at larger centers that have a high level of experience with T cell– depleted haploidentical transplantation. Less technology-dependent approaches to haploidentical transplantation, such as pharmacologic approaches with cyclophosphamide after transplantation,6 potentially should be considered as a future strategy for many pediatric HCT centers, especially those that do not have an easy access to unrelated UCB donors. Conflict-of-interest disclosure: The author declares no competing financial interests. ■