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Review
. 2016 Apr 12:9:35.
doi: 10.1186/s13045-016-0265-2.

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

Ying-Jun Chang  1 , Leo Luznik  2 , Ephraim J Fuchs  2 , Xiao-Jun Huang  3   4
Affiliations
Review

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

Ying-Jun Chang et al. J Hematol Oncol. .

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.

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

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Figures

Fig. 1
Fig. 1
Algorithm for haploidentical donor selection in unmanipulated haplo-SCT with ATG and haplo-SCT with PT/Cy. Abbreviations: haplo-SCT haploidentical stem cell transplantation; ATG anti-thymocyte globulin; PT/Cy posttransplant cyclophosphamide; TCR T-cell replete; IVIg intravenous immunoglobulin; CMV cytomegalovirus; NIMA non-inherited maternal antigen; KIR inhibitory killer cell immunoglobulin-like receptor
See this image and copyright information in PMC

References

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