Perspective on the role of haploidentical transplantation in the management of hematologic malignancies: why do it?

Curr Hematol Malig Rep. 2007 Jul;2(3):202-7. doi: 10.1007/s11899-007-0027-x.

Abstract

Haploidentical hematopoietic stem cell transplantation (HSCT) using mismatched family member donors has historically been complicated by high rates of nonrelapse toxicity and the need for laboratory expertise in depleting grafts of T lymphocytes. Over the past decade, improvements in supportive care, the increased use of peripheral-blood stem cell grafts, and improved T-cell depletion techniques have reduced the incidence of graft failure and lowered the rate of nonrelapse mortality. In addition, clinical studies have demonstrated that the donor-recipient mismatch may be beneficial in this setting, stimulating an immunologic cell-mediated antileukemia effect that results in lower disease recurrence rates. All of these advances have led to improvements in outcomes following haploidentical HSCT, making it an attractive option available to some patients. Because most patients do not have a matched related donor available and time to identify an unrelated donor may be excessive, haploidentical HSCT is a potentially curative option for these patients.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Combined Modality Therapy
  • Cord Blood Stem Cell Transplantation / adverse effects
  • Cord Blood Stem Cell Transplantation / statistics & numerical data
  • Family
  • Graft vs Host Disease / etiology
  • Graft vs Host Disease / prevention & control
  • Graft vs Leukemia Effect
  • Haplotypes
  • Hematologic Neoplasms / drug therapy
  • Hematologic Neoplasms / genetics
  • Hematologic Neoplasms / surgery*
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Hematopoietic Stem Cell Transplantation* / methods
  • Hematopoietic Stem Cell Transplantation* / statistics & numerical data
  • Histocompatibility
  • Humans
  • Leukocyte Reduction Procedures
  • Living Donors
  • Peripheral Blood Stem Cell Transplantation / adverse effects
  • Peripheral Blood Stem Cell Transplantation / statistics & numerical data
  • Transplantation Conditioning / adverse effects
  • Transplantation Conditioning / methods
  • Transplantation, Homologous / adverse effects
  • Treatment Outcome