Hematopoietic stem cell transplantation from full-haplotype mismatched donors.
Until a decade ago, hematopoietic stem cell transplantation from related donor mismatched at two or three HLA-A, -B or DR loci was largely unsuccessful in leukemia patients because of severe graft-versus-host disease in unmanipulated bone marrow transplants and graft failure in extensively T-cell-depleted transplants. The breakthrough came with the use of a megadose of T-cell-depleted hematopoietic progenitor cells. Donor-vs-recipient natural killer cell alloreactivity also plays a role in facilitating engraftment and in preventing relapse of acute myeloid leukemia. Event-free survival and transplant-related mortality for high risk acute leukemia patients treated at less advanced stages of disease compare favourably with reports from unrelated matched transplants.
D006239:Haplotypes / Q000276:immunology*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods* / Q000401:mortality; D006648:Histocompatibility / Q000276:immunology*; D006801:Humans; D007938:Leukemia / Q000401:mortality / Q000628:therapy; D008212:Lymphocyte Depletion; D014019:Tissue Donors; D014184:Transplantation, Homologous / Q000276:immunology / Q000379:methods / Q000401:mortality