Review Article Choice of Unmanipulated T Cell Replete Graft for Haploidentical Stem Cell Transplant and Posttransplant Cyclophosphamide in Hematologic Malignancies in Adults: Peripheral Blood or Bone Marrow—Review of Published Literature
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چکیده
Allogeneic hematopoietic stem cell transplantation (SCT) is often the only curative option for many patients with malignant and benign hematological stem cell disorders. However, some issues are still of concern regarding finding a donor like shrinking family sizes in many societies, underrepresentation of the ethnic minorities in the registries, genetic variability for some races, and significant delays in obtaining stem cells after starting the search. So there is a considerable need to develop alternate donor stem cell sources. The rapid and near universal availability of the haploidentical donor is an advantage of the haploidentical SCT and an opportunity that is being explored currently in many centers especially using T cell replete graft and posttransplant cyclophosphamide. This is probably because it does not require expertise in graft manipulation and because of the lower costs. However, there are still lots of unanswered questions, like the effect of use of bone marrow versus peripheral blood as the source of stem cells on graft-versus-host disease, graft versus tumor, overall survival, immune reconstitution, and quality of life. Here we review the available publications on bone marrow and peripheral blood experience in the haploidentical SCT setting.
منابع مشابه
Haploidentical Family Donor Transplantation: At the Crossroads of a Changing Paradigm
The obvious advantage of haploidentical hematopoietic stem cell transplantation (HSCT) is that almost every patient who does not have HLA-identical donor or who urgently needs transplantation has at least one family member with whom to share one haplotype and who is promptly available as a donor. Over the past decade, haploidentical HSCT has spread to centers worldwide and several hundred patie...
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In this issue of Blood, Wang et al suggest an algorithm for the selection of the best donor in HLA haplotype-mismatched transplantation of T-replete granulocyte colony-stimulating factor (G-CSF)-mobilized bone marrow and peripheral blood stem cells. Donor selection in HLA haplotypemismatched stem cells transplantation might have a significant impact on the development of acute and chronic graft...
متن کاملReview Article HLA Haplotype Mismatch Transplants and Posttransplant Cyclophosphamide
The use of high dose posttransplant cyclophosphamide (PT-CY) introduced by the Baltimore group approximately 10 years ago has been rapidly adopted worldwide and is becoming a standard for patients undergoing unmanipulated haploidentical (HAPLO) transplants. PT-CY has been used following nonmyeloablative as well as myeloablative conditioning regimens, for bone marrow or peripheral blood grafts, ...
متن کاملHaploidentical Hematopoietic Stem-Cell Transplantation in Adults
Haploidentical hematopoietic stem-cell transplantation is an alternative transplant strategy for patients without an HLA-matched donor. Still, only half of patients who might benefit from transplantation are able to find an HLA-matched related or unrelated donor. Haploidentical donor is readily available for many patients in need of immediate stem-cell transplantation. Historical experience wit...
متن کاملMobilized Peripheral Blood Stem Cells Versus Unstimulated Bone Marrow As a Graft Source for T-Cell-Replete Haploidentical Donor Transplantation Using Post-Transplant Cyclophosphamide.
Purpose T-cell-replete HLA-haploidentical donor hematopoietic transplantation using post-transplant cyclophosphamide was originally described using bone marrow (BM). With increasing use of mobilized peripheral blood (PB), we compared transplant outcomes after PB and BM transplants. Patients and Methods A total of 681 patients with hematologic malignancy who underwent transplantation in the Unit...
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تاریخ انتشار 2016