Farhadfar Nosha, Hogan William J
Nosha Farhadfar, William J Hogan, Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, United States.
World J Transplant. 2016 Dec 24;6(4):665-674. doi: 10.5500/wjt.v6.i4.665.
Allogeneic hematopoietic stem cell transplant (HSCT) remains the only potentially curative option for variety of hematologic disorders. Lack of a suitable fully HLA-matched donor limits this option for many patients. Without a suitable related or unrelated HLA-matched donor, umbilical cord blood and haploidentical family members provide a potential source of stem cells. Timely donor availability makes haploidentical donors an attractive alternative donor source. Initial attempts at haploidentical HSCT was associated with significantly increased mortality owing to high rates of graft rejection and severe graft-versus-host disease caused by major donor-recipient HLA-disparity. However, over the past decade, outcomes of haploidentical HSCT have improved significantly. Here, we review the advantages and challenges of haploidentical transplantation. We also discuss new developments to attempt to overcome the challenges to a successful haploidentical transplantation.
异基因造血干细胞移植(HSCT)仍然是治疗多种血液系统疾病唯一可能治愈的选择。缺乏合适的完全人类白细胞抗原(HLA)匹配供体限制了许多患者使用这一治疗方案。若没有合适的相关或无关HLA匹配供体,脐带血和单倍体相合家庭成员可提供潜在的干细胞来源。供体的及时可得性使单倍体相合供体成为有吸引力的替代供体来源。由于主要供受者HLA差异导致的高移植排斥率和严重移植物抗宿主病,早期单倍体相合HSCT尝试与死亡率显著增加相关。然而,在过去十年中,单倍体相合HSCT的结果有了显著改善。在此,我们综述单倍体相合移植的优势和挑战。我们还讨论了为尝试克服成功进行单倍体相合移植的挑战而取得的新进展。