PMID- 26637725
OWN - NLM
STAT- MEDLINE
DCOM- 20161005
LR  - 20161230
IS  - 1520-4383 (Electronic)
IS  - 1520-4383 (Linking)
VI  - 2015
DP  - 2015
TI  - Use of alternative donors for allogeneic stem cell transplantation.
PG  - 220-4
LID - 10.1182/asheducation-2015.1.220 [doi]
AB  - For patients without a human leukocyte antigen (HLA)-matched sibling or unrelated 
      donor, options include transplantation from HLA-mismatched related donors, 
      HLA-mismatched unrelated donors, or unrelated cord blood units. Graft failure 
      remains a problem in 10%-20% of cord blood transplants that contain a limited 
      number of hematopoietic cells. Many approaches are tested in clinical trials to 
      offset the risk of graft failure after cord blood transplantation. GVHD remains a 
      hurdle with any HLA mismatched graft. The use of post-transplant cyclophosphamide 
      holds the promise to overcome the HLA barrier and prevent GVHD despite donor 
      mismatch for a full HLA haplotype. Priority should be given to enrolling patients 
      onto transplant protocols addressing the fundamental problems of engraftment, 
      GVHD, relapse or treatment-related mortality tested with one or more of the 
      alternative stem cell sources. Principles for prioritization of alternative stem 
      cell sources are discussed separately for children and adults who cannot be 
      enrolled on clinical trials. It is difficult ranking currently available sources 
      in the face of multiple factors affecting outcomes, rapidly changing transplant 
      technology and without results from comparative trials.
CI  - (c) 2015 by The American Society of Hematology. All rights reserved.
FAU - Anasetti, Claudio
AU  - Anasetti C
AD  - Moffitt Cancer Center, Tampa, FL.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Hematology Am Soc Hematol Educ Program
JT  - Hematology. American Society of Hematology. Education Program
JID - 100890099
RN  - 0 (HLA Antigens)
RN  - 8N3DW7272P (Cyclophosphamide)
SB  - IM
MH  - Adult
MH  - *Blood Donors
MH  - Child
MH  - Clinical Trials as Topic
MH  - Cyclophosphamide/therapeutic use
MH  - Female
MH  - Fetal Blood/cytology
MH  - Graft vs Host Disease
MH  - HLA Antigens/chemistry
MH  - Haplotypes
MH  - Hematopoietic Stem Cell Transplantation/*methods
MH  - Hematopoietic Stem Cells/cytology
MH  - Humans
MH  - Killer Cells, Natural/cytology
MH  - Major Histocompatibility Complex
MH  - Male
MH  - Recurrence
MH  - Registries
MH  - Risk
MH  - Transplantation, Homologous/*methods
MH  - Unrelated Donors
EDAT- 2015/12/08 06:00
MHDA- 2016/10/07 06:00
CRDT- 2015/12/06 06:00
PHST- 2015/12/06 06:00 [entrez]
PHST- 2015/12/08 06:00 [pubmed]
PHST- 2016/10/07 06:00 [medline]
AID - 2015/1/220 [pii]
AID - 10.1182/asheducation-2015.1.220 [doi]
PST - ppublish
SO  - Hematology Am Soc Hematol Educ Program. 2015;2015:220-4. doi: 
      10.1182/asheducation-2015.1.220.