HLA-haploidentical stem cell transplantation for hematologic malignancies.
Partially HLA-mismatched related, or HLA-haploidentical, donor stem cell transplantation (SCT) is a feasible therapeutic option for advanced hematologic malignancies patients who lack an HLA-matched related or unrelated donor. Advances in conditioning regimens, graft manipulation, and pharmacologic prophylaxis of graft-versus-host disease (GVHD) have reduced the risk of fatal graft failure and severe GVHD, two of the most serious complications of traversing the HLA barrier. Clinical observations reveal a potential role for natural killer (NK) cell alloreactivity in reducing the risk of relapse of acute myeloid leukemia after HLA-haploidentical SCT. NK cell infusions attempt to harness the graft-versus-leukemia effect without producing GVHD. The availability of multiple potential HLA-haploidentical related donors for most patients opens the possibility of optimizing transplantation outcome through intelligent donor selection.
Fuchs
Ephraim J
EJ
Division of Hematologic Malignancies, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland 21231, USA. fuchsep@hmi.edu
Huang
Xiao-jun
XJ
Miller
Jeffrey S
JS
D006680:HLA Antigens / Q000235:genetics / Q000276:immunology*; D019337:Hematologic Neoplasms / Q000276:immunology / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007694:Killer Cells, Natural / Q000276:immunology / Q000637:transplantation; D019172:Transplantation Conditioning / Q000379:methods
D006680:HLA Antigens