Transplantation of haploidentically mismatched stem cells for the treatment of malignant diseases

Springer Seminars in Immunopathology
Franco Aversa, Massimo F Martelli

Abstract

Hematopoietic stem cell transplantation (HSCT) from HLA haploidentical mismatched donors has recently been developed for patients with high-risk acute leukemia who do not have a matched donor. After a high intensity conditioning regimen the HLA barrier is overcome by infusing a graft containing a megadose of T cell-depleted progenitor cells. Nowadays, for graft processing automated peripheral blood CD34(+) cell immunoselection is time and labor saving and ensures a high CD34(+) cell recovery rate. Besides providing 4.5 log T cell depletion of the graft, it guarantees a 3.5 log B cell depletion, which helps prevent EBV-related lymphoproliferative disorders. Excellent engraftment rates are associated with a very low incidence of graft-versus-host disease and regimen-related mortality even in patients who are over 40 years old. Overall, event-free survival and transplant-related mortality compare favorably with reports from unrelated matched transplants. Donor natural killer cell alloreactivity also plays a role in improving outcome in patients with acute myeloid leukemia. These results show the haploidentical transplant to be a viable, alternative source of stem cells for adults with acute leukemia at high-risk of relapse who do ...Continue Reading

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Citations

May 25, 2011·Immunology and Cell Biology·Stéphanie Humblet-BaronAdrian Liston
Nov 11, 2010·Transplant International : Official Journal of the European Society for Organ Transplantation·Jinpu YuXishan Hao
Jun 9, 2015·Cellular & Molecular Immunology·Hanyu ZengLihua Chen
Nov 7, 2006·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Thea M FriedmanRobert A Preti
Jan 27, 2009·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Xiao-Jun HuangDao-Pei Lu
Mar 29, 2011·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Yong-Xian HuHe Huang
Oct 6, 2011·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Zheng-Ping YuGang Zhao
Mar 7, 2007·The Journal of Immunology : Official Journal of the American Association of Immunologists·Evert-Jan WilsJan J Cornelissen
Jul 9, 2009·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Huang Xiao-JunTang Fei-Fei
Apr 6, 2021·Hematology, Transfusion and Cell Therapy·Cesar Homero Gutiérrez-AguirreOlga Graciela Cantú-Rodríguez

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