How do we choose the best donor for T-cell-replete, HLA-haploidentical transplantation?

Ying Jun Chang, Leo Luznik, Ephraim J. Fuchs, Xiao Jun Huang

Research output: Contribution to journalReview articlepeer-review

Abstract

In haploidentical stem cell transplantations (haplo-SCT), nearly all patients have more than one donor. A key issue in the haplo-SCT setting is the search for the best donor, because donor selection can significantly impact the incidences of acute and chronic graft-versus-host disease, transplant-related mortality, and relapse, in addition to overall survival. In this review, we focused on factors associated with transplant outcomes following unmanipulated haplo-SCT with anti-thymocyte globulin (ATG) or after T-cell-replete haplo-SCT with post-transplantation cyclophosphamide (PT/Cy). We summarized the effects of the primary factors, including donor-specific antibodies against human leukocyte antigens (HLA); donor age and gender; killer immunoglobulin-like receptor-ligand mismatches; and non-inherited maternal antigen mismatches. We also offered some expert recommendations and proposed an algorithm for selecting donors for unmanipulated haplo-SCT with ATG and for T-cell-replete haplo-SCT with PT/Cy.

Original languageEnglish (US)
Article number35
JournalJournal of Hematology and Oncology
Volume9
Issue number1
DOIs
StatePublished - 2016

Keywords

  • Age
  • Donor
  • Donor-specific anti-human leukocyte antigen antibody
  • Natural killer alloreactivity
  • Non-inherited maternal antigen mismatch
  • Unmanipulated haploidentical stem cell transplantation

ASJC Scopus subject areas

  • Molecular Biology
  • Hematology
  • Oncology
  • Cancer Research

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