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Nonmyeloablative allogeneic hematopoietic stem cell transplant using mismatched/haploidentical donors: a review.

Publication ,  Journal Article
Koh, L-P; Chao, NJ
Published in: Blood Cells Mol Dis
2008

Haploidentical hematopoietic stem cell transplantation (HSCT) provides an opportunity for patients to benefit from HCT when a human leukocyte antigen (HLA) genotypically matched sibling is not available. Initial results with the use of mismatched allograft has been disappointing due to the high incidence of graft-versus-host disease (GVHD) and infectious complications resulting in an unacceptable treatment-related morbidity and mortality. Recent advances with effective T-cell depletion, the use of 'megadose' of stem cells and reduced intensity conditioning has significantly decreased the early transplant related mortality and GvHD, while enabling robust and prompt engraftment, and hence enhancing the therapeutic benefits of haploidentical transplantation. However, the cardinal problems related to delayed immune reconstitution causing posttransplant infectious complications and relapse remain, limiting the efficacy of haploidentical transplant. Preliminary data have demonstrated the great potential in the use of adoptive cellular immunity and selective allodepletion in rapidly reconstituting immunity without GvHD. The encouraging reports from haploidentical transplant using noninherited maternal antigen (NIMA)-mismatched donors or natural killer alloreactive donors may greatly increase the donor availability and open a way to more appropriate donor selection in HLA-haploidentical HSCT. Future challenges remain in determining the safest approach for haploidentical transplant to be performed with minimal risk of GvHD, while preserving effective graft-versus-leukemia activity and promoting prompt immune reconstitution.

Duke Scholars

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Published In

Blood Cells Mol Dis

DOI

ISSN

1079-9796

Publication Date

2008

Volume

40

Issue

1

Start / End Page

20 / 24

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Transplantation Conditioning
  • Immunology
  • Humans
  • Histocompatibility
  • Hematopoietic Stem Cell Transplantation
  • Haplotypes
  • 1103 Clinical Sciences
 

Citation

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Chicago
ICMJE
MLA
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Koh, L.-P., & Chao, N. J. (2008). Nonmyeloablative allogeneic hematopoietic stem cell transplant using mismatched/haploidentical donors: a review. Blood Cells Mol Dis, 40(1), 20–24. https://doi.org/10.1016/j.bcmd.2007.06.017
Koh, Liang-Piu, and Nelson J. Chao. “Nonmyeloablative allogeneic hematopoietic stem cell transplant using mismatched/haploidentical donors: a review.Blood Cells Mol Dis 40, no. 1 (2008): 20–24. https://doi.org/10.1016/j.bcmd.2007.06.017.
Koh, Liang-Piu, and Nelson J. Chao. “Nonmyeloablative allogeneic hematopoietic stem cell transplant using mismatched/haploidentical donors: a review.Blood Cells Mol Dis, vol. 40, no. 1, 2008, pp. 20–24. Pubmed, doi:10.1016/j.bcmd.2007.06.017.
Journal cover image

Published In

Blood Cells Mol Dis

DOI

ISSN

1079-9796

Publication Date

2008

Volume

40

Issue

1

Start / End Page

20 / 24

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Transplantation Conditioning
  • Immunology
  • Humans
  • Histocompatibility
  • Hematopoietic Stem Cell Transplantation
  • Haplotypes
  • 1103 Clinical Sciences