PMID- 30582393
OWN - NLM
STAT- MEDLINE
DCOM- 20200505
LR  - 20200505
IS  - 1747-4094 (Electronic)
IS  - 1747-4094 (Linking)
VI  - 12
IP  - 1
DP  - 2019 Jan
TI  - Hematopoietic stem cell transplant with HLA-mismatched grafts: impact of donor, 
      source, conditioning, and graft versus host disease prophylaxis.
PG  - 47-60
LID - 10.1080/17474086.2019.1562331 [doi]
AB  - Allogeneic hematopoietic cell transplantation is frequently used to treat 
      malignant and non-malignant conditions, and many patients lack a human leukocyte 
      antigen (HLA) matched related or unrelated donor. For those patients, available 
      alternative graft sources include HLA mismatched unrelated donors, cord blood, or 
      haplo-identical donors. These graft sources have unique characteristics and 
      associated outcomes requiring graft-specific variations to conditioning regimens, 
      graft-versus-host disease prophylaxis, and post-transplant care. Areas covered: 
      This manuscript will cover approaches in selecting donors, conditioning regimens, 
      graft versus host disease prophylaxis, post-transplant care, and ongoing clinical 
      trials related to mismatched grafts. Expert commentary: In the setting, 
      haplo-identical grafts are increasingly popular due to low graft versus host 
      disease (GVHD) risk and control of cellular dose. We recommend young male donors, 
      utilizing bone marrow with post-transplant cyclophosphamide for GVHD prophylaxis. 
      Cord blood transplant is appropriate for young healthy patients, and we recommend 
      6/8 HLA matched grafts with at least 2.0 x 10(7)/kg total nucleated cell dose. 
      For mismatched unrelated donors we recommend young male donors, utilizing bone 
      marrow with in vivo T-cell conditioning with post-transplant cyclophosphamide, 
      alemtuzumab, or ATG. With these transplants, significant post-transplant 
      surveillance and infectious prophylaxis is key to reducing treatment-related 
      mortality.
FAU - Metheny, Leland
AU  - Metheny L
AD  - a Stem Cell Transplant Program, University Hospitals Cleveland Medical Center , 
      Case Western Reserve University , Cleveland , OH , USA.
FAU - de Lima, Marcos
AU  - de Lima M
AD  - a Stem Cell Transplant Program, University Hospitals Cleveland Medical Center , 
      Case Western Reserve University , Cleveland , OH , USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20181229
PL  - England
TA  - Expert Rev Hematol
JT  - Expert review of hematology
JID - 101485942
SB  - IM
MH  - Female
MH  - Graft vs Host Disease/*etiology
MH  - Hematopoietic Stem Cell Transplantation/*adverse effects/*methods
MH  - Histocompatibility Testing/*methods
MH  - Humans
MH  - Male
MH  - Tissue Donors
MH  - Transplantation Conditioning/*methods
OTO - NOTNLM
OT  - Cord blood
OT  - allogeneic stem cell transplant
OT  - haplo-identical
OT  - mismatched unrelated donor
EDAT- 2018/12/26 06:00
MHDA- 2020/05/06 06:00
CRDT- 2018/12/25 06:00
PHST- 2018/12/26 06:00 [pubmed]
PHST- 2020/05/06 06:00 [medline]
PHST- 2018/12/25 06:00 [entrez]
AID - 10.1080/17474086.2019.1562331 [doi]
PST - ppublish
SO  - Expert Rev Hematol. 2019 Jan;12(1):47-60. doi: 10.1080/17474086.2019.1562331. 
      Epub 2018 Dec 29.