Biology of Blood and Marrow Transplantation
Volume 16, Issue 1, Supplement , Pages S57-S63, January 2010

HLA-Haploidentical Stem Cell Transplantation for Hematologic Malignancies

  • Ephraim J. Fuchs

      Affiliations

    • Division of Hematologic Malignancies, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
    • Corresponding Author InformationCorrespondence and reprint requests: Ephraim J. Fuchs, M.D., M.B.A., Division of Hematologic Malignancies, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, 488 Cancer Research Building, 1650 Orleans Street, Baltimore, MD 21231.
  • ,
  • Xiao-jun Huang

      Affiliations

    • Institute of Hematology, People's Hospital, Peking University, Beijing, People's Republic of China
  • ,
  • Jeffrey S. Miller

      Affiliations

    • Division of Hematology, Oncology and Transplantation, University of Minnesota Cancer Center, Minneapolis, Minnesota

Received 15 September 2009; accepted 29 October 2009. published online 04 November 2009.

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.

Key Words: Stem cell transplantation, Adoptive immunotherapy, Natural killer cells, Graft-versus-host disease, Human leukocyte antigens, Transplantation conditioning

 

 Financial disclosure: See Acknowledgments on page 62.

PII: S1083-8791(09)00514-X

doi:10.1016/j.bbmt.2009.10.032

Biology of Blood and Marrow Transplantation
Volume 16, Issue 1, Supplement , Pages S57-S63, January 2010