Hematopoietic Cell Transplantation from Partially HLA-Mismatched (HLA-Haploidentical) Related Donors

摘要: Human Leukocyte Antigen-haploidentical stem cell transplantation, or HLA-haploidentical SCT, refers to the transplantation of blood marrow from a donor into recipient who is genotypically identical for one HLA haplotype and variably mismatched alleles on unshared haplotype. Typically, donors SCT are first-degree relatives, such as siblings, biological parents, children, although aunts, uncles, cousins, half-siblings may be recipient. As compared an HLA-matched sibling, distinguishing feature HLA-haploidentical, partially related (PMRD), intense, bidirectional T cell-mediated alloreactivity resulting in increased risks graft failure, severe graft-versus-host disease, nonrelapse mortality (NRM) [1-3]. The poor results early trials have motivated strategies mitigate by depleting cells both host graft. While these reduced failure GVHD, respectively, they led compensatory increase risk infectious complications prolonged immunodeficiency, possibly disease relapse. More recent efforts focused upon selective depletion alloreactive enhance immune reconstitution without risking GVHD. Advances control supportive care combined improve SCT.