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Haploidentical hematopoietic stem cell transplantation: state of art

Bone Marrow Transplantation volume 50, pages S1–S5 (2015)Cite this article

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Abstract

For patients with hematologic malignancies at high risk of relapse who do not have matched donors, a suitable alternative stem cell source is the HLA-haploidentical 2- or 3-loci mismatched family donor who is readily available for nearly all patients. Transplantation across the major HLA barrier is associated with strong T-cell alloreactions, which were originally manifested as a high incidence of severe GVHD and graft rejection. The present overview of the 7th symposium on haplidentical transplantation that took place at the Weizmann Institute on February 2014, shows how these obstacles to successful transplantation can now be overcome. The review also discusses the advantages and drawbacks of current options for full haplotype-mismatched transplantation and highlights innovative approaches for rebuilding immunity, reducing leukemia relapse and improving survival after transplantation. In addition, new modalities for immune tolerance induction following nonmyeloablative conditioning are discussed, showing new options for treatment of elderly patients who cannot tolerate myeloablative conditioning protocols, as well as novel strategies for immune tolerance and chimerism induction as a platform for cell therapy and organ transplantation.

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Acknowledgements

We thank Dr Esti Bachar-Lustig for her assistance in preparing this manuscript. YR holds the Henry Drake Professorial chair in Transplantation Immunology and is supported in part by a research grant from Roberto and Renata Ruhman.

Author information

Authors and Affiliations

  1. Department of Immunology, Weizmann Institute of Science, Rehovot, Israel

    Y Reisner

  2. Department of Medicine, Division of Hematology and Clinical Immunology, University of Perugia, Perugia, Italy

    F Aversa

  3. Department of Clinical and Experimental Medicine, Hematology and BMT Unit, University of Parma, Italy

    M F Martelli

Authors
  1. Y Reisner
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  2. F Aversa
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  3. M F Martelli
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Corresponding author

Correspondence to Y Reisner.

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Competing interests

YR has received consulting fees, owns equity in and has received grant support from Cell Source Ltd. FA has received consulting fees from Gilead, MSD, Pfizer, Genzyme, and received lecture fees from Gilead, MSD, Pfizer, and Celgene. MFM has declared no competing interests.

Additional information

This article was published as part of a supplement, supported by WIS-CSP Foundation, in collaboration with Gilead, Milteny Biotec, Gamida cell, Adienne Pharma and Biotech, Medac hematology, Kiadis Pharma, Almog Diagnostic.

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Reisner, Y., Aversa, F. & Martelli, M. Haploidentical hematopoietic stem cell transplantation: state of art. Bone Marrow Transplant 50 (Suppl 2), S1–S5 (2015). https://doi.org/10.1038/bmt.2015.86

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