Full haplotype mismatched hematopoietic stem cell transplants.
OBJECTIVE
Clinical outcome in leukemia patients transplanted from one-haplotype mismatched donors has been largely disappointing because of the high incidence of severe graft-vs-host disease in T-replete transplants or high rejection rates in T-cell-depleted transplants.


METHODS
The breakthrough came with the use of a megadose of T-cell-depleted progenitor cells after a high intensity conditioning regimen.


BACKGROUND
Today, high risk acute leukemia patients are treated at less advanced stages of disease, receive a well-tolerated conditioning regimen, and benefit from advances in post-transplant immunologic reconstitution. Overall, event-free survival and transplant-related mortality compare favorably with those reported for unrelated matched transplants.


CONCLUSIONS
T-cell depleted megadose stem cell transplant from a mismatched family member, who is immediately available, can be offered as a viable option to candidates with high-risk acute leukemias.
Aversa
Franco
F
Hematopoietic Stem Cell Transplantation Program, Section of Hematology, Department of Internal and Experimental Medicine, University of Perugia, Italy. aversa@unipg.it
D000208:Acute Disease; D018572:Disease-Free Survival; D006650:Histocompatibility Testing / Q000379:methods*; D006801:Humans; D007938:Leukemia / Q000628:therapy*; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000401:mortality; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome