Overview of the progress on haploidentical hematopoietic transplantation

Abstract

Allogeneic hematopoietic stem cell transplant (HSCT) remains the only potentially curative option for variety of hematologic disorders. Lack of a suitable fully HLA-matched donor limits this option for many patients. Without a suitable related or unrelated HLA-matched donor, umbilical cord blood and haploidentical family members provide a potential source of stem cells. Timely donor availability makes haploidentical donors an attractive alternative donor source. Initial attempts at haploidentical HSCT was associated with significantly increased mortality owing to high rates of graft rejection and severe graft-versus-host disease caused by major donor-recipient HLA-disparity. However, over the past decade, outcomes of haploidentical HSCT have improved significantly. Here, we review the advantages and challenges of haploidentical transplantation. We also discuss new developments to attempt to overcome the challenges to a successful haploidentical transplantation.

Revisión literaria sobre el trasplante de células madre hematopoyéticas, opciones para mejorar la asimilación y su impacto en la supervivencia de los pacientes

“…La recuperación completa del sistema inmune es de lo más importante para así poder asegurar la supervivencia del paciente y protegerlo de infecciones oportunistas, es por esto que por medio de la citometría de flujo se puede observar como es la reconstrucción de la inmunidad luego de los procedimientos realizados [51]. El principio de la terapia de células T es disminuir las células T aloactivas para que el riesgo de la enfermedad injerto vs huésped se disminuya al tiempo que se permite la reconstrucción del sistema inmune [52].…”

Hematopoietic Stem Cell Transplant for a New Primary Immunodeficiency Disorder: A Voyage Where No Transplant Physician Has Gone Before

“…However the prevalence of DIDS is higher in populations with high consanguinity that are not well represented in donor registries, necessitating exploration into using alternative donors. Haploidentical transplantation is historically associated with high rates of graft failure and graft-versus-host disease secondary to HLA disparity between the donor and recipient, but advances in technique, including selective T cell depletion and posttransplant cyclophosphamide, have provided excellent results in a variety of disorders with low rates of graft-versus-host disease and rapid immune reconstitution [12], critical factors for successful HSCT of PIDs.…”

Improving Storage Policy in Korean Public Cord Blood Banks: Comparison of Quality between Long-Term and Short-Term Storage of Cord Blood

“…CB is easier to obtain than bone marrow or peripheral blood stem cells, because CB is a ready-made product. The improvement of procedures for haploidentical stem cell transplantation has resulted in the decreased use of CB [3][4][5]. This has increased the financial strain on public CB banks and threatens the sustainability of public umbilical CB blood banks [6].…”