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Unmanipulated or CD34 selected haplotype mismatched transplants.

Publication ,  Journal Article
Kang, Y; Chao, NJ; Aversa, F
Published in: Curr Opin Hematol
November 2008

PURPOSE OF REVIEW: Unmanipulated or CD34 selected haplotype mismatched transplantation provides the benefits of hematopoietic stem cell transplant for nearly all patients who do not have a human leukocyte antigen fully matched sibling or who urgently need transplantation. Haplotype mismatched transplant is, however, complicated by delayed immune reconstitution, leading to increased risks of fatal posttransplant opportunistic infections. This review summarizes recent investigations aimed at optimizing outcomes. RECENT FINDINGS: The graft is a megadose of positively/negatively T-cell-depleted or unmanipulated progenitor cells. Although haploidentical transplant modalities are based mainly on high-intensity conditioning regimens, recently introduced reduced-intensity regimens showed promise in decreasing early transplant-related mortality and in extending the opportunity of hematopoietic stem cell transplantation to an elderly population with more comorbidities. Natural killer cell alloreactivity reduces graft-versus-host disease while augmenting graft-versus-malignancy. Immune reconstitution was highly predictive of outcome following T-cell-depleted transplantation. SUMMARY: Mismatched/haploidentical transplant provides an alternative approach for patients with high-risk hematological malignancies or marrow failure syndromes. Overall survival and clinical outcome continue to improve. Future challenges lie in determining the safest preparative conditioning regimen, minimizing graft-versus-host disease while preserving effective graft-versus-malignancy and promoting rapid immune reconstitution.

Duke Scholars

Published In

Curr Opin Hematol

DOI

EISSN

1531-7048

Publication Date

November 2008

Volume

15

Issue

6

Start / End Page

561 / 567

Location

United States

Related Subject Headings

  • Transplantation Immunology
  • Transplantation Conditioning
  • Immunology
  • Humans
  • Histocompatibility
  • Hematopoietic Stem Cell Transplantation
  • Haplotypes
  • Antigens, CD34
  • Animals
  • 3201 Cardiovascular medicine and haematology
 

Citation

APA
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ICMJE
MLA
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Kang, Y., Chao, N. J., & Aversa, F. (2008). Unmanipulated or CD34 selected haplotype mismatched transplants. Curr Opin Hematol, 15(6), 561–567. https://doi.org/10.1097/MOH.0b013e32831366eb
Kang, Yubin, Nelson J. Chao, and Franco Aversa. “Unmanipulated or CD34 selected haplotype mismatched transplants.Curr Opin Hematol 15, no. 6 (November 2008): 561–67. https://doi.org/10.1097/MOH.0b013e32831366eb.
Kang Y, Chao NJ, Aversa F. Unmanipulated or CD34 selected haplotype mismatched transplants. Curr Opin Hematol. 2008 Nov;15(6):561–7.
Kang, Yubin, et al. “Unmanipulated or CD34 selected haplotype mismatched transplants.Curr Opin Hematol, vol. 15, no. 6, Nov. 2008, pp. 561–67. Pubmed, doi:10.1097/MOH.0b013e32831366eb.
Kang Y, Chao NJ, Aversa F. Unmanipulated or CD34 selected haplotype mismatched transplants. Curr Opin Hematol. 2008 Nov;15(6):561–567.

Published In

Curr Opin Hematol

DOI

EISSN

1531-7048

Publication Date

November 2008

Volume

15

Issue

6

Start / End Page

561 / 567

Location

United States

Related Subject Headings

  • Transplantation Immunology
  • Transplantation Conditioning
  • Immunology
  • Humans
  • Histocompatibility
  • Hematopoietic Stem Cell Transplantation
  • Haplotypes
  • Antigens, CD34
  • Animals
  • 3201 Cardiovascular medicine and haematology