PMID- 17884641
OWN - NLM
STAT- MEDLINE
DCOM- 20080226
LR  - 20181113
IS  - 1079-9796 (Print)
IS  - 1096-0961 (Electronic)
IS  - 1079-9796 (Linking)
VI  - 40
IP  - 1
DP  - 2008 Jan-Feb
TI  - Nonmyeloablative allogeneic hematopoietic stem cell transplant using 
      mismatched/haploidentical donors: a review.
PG  - 20-4
AB  - Haploidentical hematopoietic stem cell transplantation (HSCT) provides an 
      opportunity for patients to benefit from HCT when a human leukocyte antigen (HLA) 
      genotypically matched sibling is not available. Initial results with the use of 
      mismatched allograft has been disappointing due to the high incidence of 
      graft-versus-host disease (GVHD) and infectious complications resulting in an 
      unacceptable treatment-related morbidity and mortality. Recent advances with 
      effective T-cell depletion, the use of 'megadose' of stem cells and reduced 
      intensity conditioning has significantly decreased the early transplant related 
      mortality and GvHD, while enabling robust and prompt engraftment, and hence 
      enhancing the therapeutic benefits of haploidentical transplantation. However, 
      the cardinal problems related to delayed immune reconstitution causing 
      posttransplant infectious complications and relapse remain, limiting the efficacy 
      of haploidentical transplant. Preliminary data have demonstrated the great 
      potential in the use of adoptive cellular immunity and selective allodepletion in 
      rapidly reconstituting immunity without GvHD. The encouraging reports from 
      haploidentical transplant using noninherited maternal antigen (NIMA)-mismatched 
      donors or natural killer alloreactive donors may greatly increase the donor 
      availability and open a way to more appropriate donor selection in 
      HLA-haploidentical HSCT. Future challenges remain in determining the safest 
      approach for haploidentical transplant to be performed with minimal risk of GvHD, 
      while preserving effective graft-versus-leukemia activity and promoting prompt 
      immune reconstitution.
FAU - Koh, Liang-Piu
AU  - Koh LP
AD  - Adult Bone Marrow and Stem Cell Transplantation Program, Duke University Medical 
      Center, Durham, NC, USA.
FAU - Chao, Nelson J
AU  - Chao NJ
LA  - eng
GR  - P01 CA047741/CA/NCI NIH HHS/United States
GR  - P01 CA047741-15/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Review
DEP - 20070919
PL  - United States
TA  - Blood Cells Mol Dis
JT  - Blood cells, molecules & diseases
JID - 9509932
SB  - IM
MH  - *Haplotypes
MH  - Hematopoietic Stem Cell Transplantation/*methods
MH  - *Histocompatibility
MH  - Humans
MH  - Transplantation Conditioning/*methods
MH  - Treatment Outcome
PMC - PMC2330277
MID - NIHMS37098
EDAT- 2007/09/22 09:00
MHDA- 2008/02/27 09:00
PMCR- 2009/01/01
CRDT- 2007/09/22 09:00
PHST- 2007/06/25 00:00 [received]
PHST- 2007/06/30 00:00 [revised]
PHST- 2007/06/30 00:00 [accepted]
PHST- 2007/09/22 09:00 [pubmed]
PHST- 2008/02/27 09:00 [medline]
PHST- 2007/09/22 09:00 [entrez]
PHST- 2009/01/01 00:00 [pmc-release]
AID - S1079-9796(07)00135-0 [pii]
AID - 10.1016/j.bcmd.2007.06.017 [doi]
PST - ppublish
SO  - Blood Cells Mol Dis. 2008 Jan-Feb;40(1):20-4. doi: 10.1016/j.bcmd.2007.06.017. 
      Epub 2007 Sep 19.