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Haploidentical Hematopoietic Stem Cell Transplantation: Expanding the Horizon for Hematologic Disorders

Despite the advent of targeted therapies and novel agents, allogeneic hematopoietic stem cell transplantation remains the only curative modality in the management of hematologic disorders. The necessity to find an HLA-matched related donor is a major obstacle that compromises the widespread applicat...

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Detalles Bibliográficos
Autores principales: Zahid, Mohammad Faizan, Rizzieri, David Alan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4754478/
https://www.ncbi.nlm.nih.gov/pubmed/26949395
http://dx.doi.org/10.1155/2016/1423493
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author Zahid, Mohammad Faizan
Rizzieri, David Alan
author_facet Zahid, Mohammad Faizan
Rizzieri, David Alan
author_sort Zahid, Mohammad Faizan
collection PubMed
description Despite the advent of targeted therapies and novel agents, allogeneic hematopoietic stem cell transplantation remains the only curative modality in the management of hematologic disorders. The necessity to find an HLA-matched related donor is a major obstacle that compromises the widespread application and development of this field. Matched unrelated donors and umbilical cord blood have emerged as alternative sources of donor stem cells; however, the cost of maintaining donor registries and cord blood banks is very high and even impractical in developing countries. Almost every patient has an HLA haploidentical relative in the family, meaning that haploidentical donors are potential sources of stem cells, especially in situations where cord blood or matched unrelated donors are not easily available. Due to the high rates of graft failure and graft-versus-host disease, haploidentical transplant was not considered a feasible option up until the late 20th century, when strategies such as “megadose stem cell infusions” and posttransplantation immunosuppression with cyclophosphamide showed the ability to overcome the HLA disparity barrier and significantly improve the rates of engraftment and reduce the incidence and severity of graft-versus-host disease. Newer technologies of graft manipulation have also yielded the same effects in addition to preserving the antileukemic cells in the donor graft.
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spelling pubmed-47544782016-03-06 Haploidentical Hematopoietic Stem Cell Transplantation: Expanding the Horizon for Hematologic Disorders Zahid, Mohammad Faizan Rizzieri, David Alan Adv Hematol Review Article Despite the advent of targeted therapies and novel agents, allogeneic hematopoietic stem cell transplantation remains the only curative modality in the management of hematologic disorders. The necessity to find an HLA-matched related donor is a major obstacle that compromises the widespread application and development of this field. Matched unrelated donors and umbilical cord blood have emerged as alternative sources of donor stem cells; however, the cost of maintaining donor registries and cord blood banks is very high and even impractical in developing countries. Almost every patient has an HLA haploidentical relative in the family, meaning that haploidentical donors are potential sources of stem cells, especially in situations where cord blood or matched unrelated donors are not easily available. Due to the high rates of graft failure and graft-versus-host disease, haploidentical transplant was not considered a feasible option up until the late 20th century, when strategies such as “megadose stem cell infusions” and posttransplantation immunosuppression with cyclophosphamide showed the ability to overcome the HLA disparity barrier and significantly improve the rates of engraftment and reduce the incidence and severity of graft-versus-host disease. Newer technologies of graft manipulation have also yielded the same effects in addition to preserving the antileukemic cells in the donor graft. Hindawi Publishing Corporation 2016 2016-02-02 /pmc/articles/PMC4754478/ /pubmed/26949395 http://dx.doi.org/10.1155/2016/1423493 Text en Copyright © 2016 M. F. Zahid and D. A. Rizzieri. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Zahid, Mohammad Faizan
Rizzieri, David Alan
Haploidentical Hematopoietic Stem Cell Transplantation: Expanding the Horizon for Hematologic Disorders
title Haploidentical Hematopoietic Stem Cell Transplantation: Expanding the Horizon for Hematologic Disorders
title_full Haploidentical Hematopoietic Stem Cell Transplantation: Expanding the Horizon for Hematologic Disorders
title_fullStr Haploidentical Hematopoietic Stem Cell Transplantation: Expanding the Horizon for Hematologic Disorders
title_full_unstemmed Haploidentical Hematopoietic Stem Cell Transplantation: Expanding the Horizon for Hematologic Disorders
title_short Haploidentical Hematopoietic Stem Cell Transplantation: Expanding the Horizon for Hematologic Disorders
title_sort haploidentical hematopoietic stem cell transplantation: expanding the horizon for hematologic disorders
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4754478/
https://www.ncbi.nlm.nih.gov/pubmed/26949395
http://dx.doi.org/10.1155/2016/1423493
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