Microtransplantation: clinical applications and mechanisms.

PURPOSE OF REVIEW

Microtransplantation (MST) has been successfully used to manage patients with hematological malignancies, especially older patients with acute myeloid leukemia (AML). Recent clinical applications and mechanistic studies of MST are reviewed.

RECENT FINDINGS

MST improves complete remission rates which have no significant difference among age groups in older patients with AML. Sufficient courses of postremission therapy lead to prolonged overall survival and reduced relapse rate. MST also benefits young patients with low-risk or intermediate-risk AML who lack a human leukocyte antigen-identical donor and shows therapeutic potential extending to other malignancies. Both donor and recipient-derived T cells contribute to the antileukemic effect. Novel methods to monitor donor microchimerism and donor-recipient immune cell interaction may further unveil mechanisms of MST.

SUMMARY

MST shows therapeutic efficacy to several hematological malignancies, whereas mechanistic studies still need to be promoted, and its combination with other targeted therapies is warranted to further reduce relapse rate.