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We retrospectively investigated outcomes of haploidentical donor ( HID) transplant for adults with standard-risk acute lymphoblastic leukaemia ( ALL) in first complete remission ( CR1) compared with human leucocyte antigen ( HLA)-matched sibling donor ( MSD) and HLA-matched unrelated donor ( MUD) transplants. A total of 348 adult patients were enrolled, including 127 HID, 144 MSD and 77 MUD recipients. The cumulative incidence of grade II- IV acute graft- versus-host disease ( aGVHD) was 39·5%, 24·0% and 40·3% for HID, MSD and MUD, respectively ( P = 0·020). However, there was no difference in grade III- IV aGVHD (11·4%, 7·7%, 13·5%, respectively, P = 0·468). The 5-year cumulative transplant-related mortality was 16·4%, 11·6% and 19·6% ( P = 0·162), the 5-year relapse rate post-transplantation was 14·8%, 21·1% and 16·7% ( P = 0·231), the 5-year overall survival was 70·1%, 73·7% and 69·8% ( P = 0·525), and the 5-year disease-free survival was 68·7%, 67·3% and 63·7%, respectively ( P = 0·606). Furthermore, the 3-year GVHD-free, relapse-free survival was not different (50·8%, 54·9% and 52·2%, respectively, P = 0·847). Our results indicate that the outcomes of HID transplants are equivalent to those of MSD and MUD, and that HID transplantation is a valid alternative for standard-risk adults with ALL in CR1 who lack matched donors. [ABSTRACT FROM AUTHOR]