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Haploidentical haematopoietic stem cell transplantation for acute leukaemia in adults: experience in Europe and the United States

Bone Marrow Transplantation volume 41, pages 473–481 (2008)Cite this article

Abstract

Work on one haplotype-mismatched transplants has been proceeding for over 20 years all over the world and novel transplant techniques have been developed. Some centres have focused on the conditioning regimens and post transplant immune suppression; others have concentrated on manipulating the graft. Haploidentical transplant modalities are based mainly on high-intensity conditioning regimen, but reduced intensity regimens have recently been introduced. The graft may be a megadose of extensively T cell-depleted or unmanipulated progenitor cells. Excellent engraftment rates are associated with a very low incidence of GVHD- and regimen-related mortality even in patients who are over 50 years old. Overall, event-free survival and transplant-related mortality compare favourably with reports on transplants from sources of stem cells other than the matched sibling. Improvements will come with successful implementation of strategies to accelerate and strengthen post transplant immune reconstitution as well as transplantation of patients in early stage disease.

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References

  1. Byrd JC, Mrózek K, Dodge RK, Carroll AJ, Edwards CG, Arthur DC et al. Pretreatment cytogenetic abnormalities are predictive of induction success, cumulative incidence of relapse, and overall survival in adult patients with de novo acute myeloid leukemia: results from Cancer and Leukemia Group B (CALGB 8461). Blood 2002; 100: 4325–4336.

    CAS  PubMed  Google Scholar 

  2. Burnett AK, Wheatley K, Goldstone AH, Stevens RF, Hann IM, Rees JH et al. Medical Research Council Adult and Paediatric Working Parties. The value of allogeneic bone marrow transplant in patients with acute myeloid leukaemia at differing risk of relapse: results of the UK MRC AML 10 trial. Br J Haematol 2002; 118: 385–400.

    PubMed  Google Scholar 

  3. Biggs JC, Horowitz MM, Gale RP, Ash RC, Atkinson K, Helbig W et al. Bone marrow transplants may cure patients with acute leukemia never achieving remission with chemotherapy. Blood 1992; 80: 1090–1093.

    CAS  PubMed  Google Scholar 

  4. Forman SJ, Schmidt GM, Nademanee AP, Amylon MD, Chao NJ, Fahey JL et al. Allogeneic bone marrow transplantation as therapy for primary induction failure for patients with acute leukemia. J Clin Oncol 1991; 9: 1570–1574.

    CAS  PubMed  Google Scholar 

  5. Hansen JA, Petersdorf E, Martin PJ, Anasetti C . Hematopoietic stem cell transplants from unrelated donors. Immunol Rev 1997; 157: 141–151.

    CAS  PubMed  Google Scholar 

  6. Rocha V, Labopin M, Sanz G, Arcese W, Schwerdtfeger R, Bosi A et al. Transplants of umbilical cord blood or bone marrow from unrelated donors in adult with leukemia. N Engl J Med 2004; 351: 2276–2285.

    Article  CAS  PubMed  Google Scholar 

  7. Sanz MA, Sanz GF . Unrelated donor umbelical cord blood transplantation in adults. Leukemia 2002; 16: 1984–1991.

    CAS  PubMed  Google Scholar 

  8. Brunstein CG, Setubal DC, Wagner JE . Expanding the role of umbilical cord blood transplantation. Br J Haematol 2007; 137: 20–35.

    PubMed  Google Scholar 

  9. Ruggeri L, Capanni M, Urbani E, Perruccio K, Shlomchik WD, Tosti A et al. Effectiveness of donor natural killer cell alloreactivity in mismatched hematopoietic transplants. Science 2002; 295: 2097–2100.

    CAS  PubMed  Google Scholar 

  10. Aversa F, Berneman ZN, Locatelli F, Martelli MF, Reisner Y, Tabilio A et al. Fourth International Workshop on Haploidentical Transplants, Naples, Italy, 8–10 July, 2004. Blood Cells Mol Dis 2004; 33: 159–175.

    PubMed  Google Scholar 

  11. Reisner Y, Kapoor N, Kirkpatrick D, Pollack MS, Cunningham-Rundles S, Dupont B et al. Transplantation for severe combined immunodeficiency with HLA-A, B, D, DR incompatible parental marrow cells fractionated by soybean agglutinin and sheep red blood cells. Blood 1983; 61: 341–348.

    CAS  PubMed  Google Scholar 

  12. Anasetti C, Beatty PG, Storb R, Martin PJ, Mori M, Sanders JE et al. Effect of HLA incompatibility on graft-versus-host disease, relapse, and survival after marrow transplantation for patients with leukemia or lymphoma. Hum Immunol 1990; 29: 79–91.

    CAS  PubMed  Google Scholar 

  13. Kernan NA, Flomemberg N, Dupont B, O'Reilly RJ . Graft rejection in recipients of T cell depleted HLA-nonidentical marrow transplants for leukemia: identification of host derived anti-donor allocytotoxic T lymphocytes. Transplantation 1987; 43: 482–487.

    Google Scholar 

  14. Henslee-Downey PJ, Abhyankar SH, Parrish RS, Pati AR, Godder KT, Neglia WJ et al. Use of partially mismatched related donors extends access to allogeneic marrow transplant. Blood 1997; 89: 3864–3872.

    CAS  PubMed  Google Scholar 

  15. Schwartz E, Lapidot T, Gozes D, Singer TS, Reisner Y . Abrogation of bone marrow allograft resistance in mice by increased total body irradiation correlates with eradication of host clonable T cells and alloreactive cytotoxic precursors. J Immunol 1987; 138: 460–465.

    CAS  PubMed  Google Scholar 

  16. Lapidot T, Singer TS, Salomon O, Terenzi A, Schwartz E, Reisner Y . Booster irradiation to the spleen following total body irradiation: a new immunosuppressive approach for allogeneic bone marrow transplantation. J Immunol 1988; 141: 2619–2624.

    CAS  PubMed  Google Scholar 

  17. Cobbold SP, Martin G, Quin S, Waldman H . Monoclonal antibodies to promote marrow engraftment and tissue graft tolerance. Nature 1986; 323: 164–166.

    CAS  PubMed  Google Scholar 

  18. Lapidot T, Terenzi A, Singer TS, Salomon O, Reisner Y . Enhancement by dimethyl myleran of donor type chimerism in murine recipients of bone marrow allografts. Blood 1989; 73: 2025–2032.

    CAS  PubMed  Google Scholar 

  19. Terenzi A, Lubin I, Lapidot T, Salomon O, Faktorowich Y, Rabi I et al. Enhancement of T cell-depleted bone marrow allografts in mice by thiotepa. Transplantation 1990; 50: 717–720.

    CAS  PubMed  Google Scholar 

  20. Aversa F, Tabilio A, Terenzi A, Velardi A, Falzetti F, Giannoni C et al. Successful engraftment of T cell-depleted haploidentical ‘three-loci’ incompatible transplants in leukemia patients by addition of recombinant human granulocyte colony-stimulating factor-mobilized peripheral blood progenitor cells to bone marrow inoculum. Blood 1994; 84: 3948–3955.

    CAS  PubMed  Google Scholar 

  21. Bachar-Lustig E, Rachamim N, Li HW, Lan F, Reisner Y . Megadose of T cell-depleted bone marrow overcomes MHC barriers in sublethally irradiated mice. Nat Med 1995; 1: 1268–1273.

    CAS  PubMed  Google Scholar 

  22. Rachamim N, Gan J, Segall H, Krauthgamer R, Marcus H, Berrebi A et al. Tolerance induction by ‘megadose’ hematopoietic transplants: donor-type human CD34 stem cells induce potent specific reduction of host anti-donor cytotoxic T lymphocyte precursors in mixed lymphocyte culture. Transplantation 1998; 65: 1386–1393.

    CAS  PubMed  Google Scholar 

  23. Gur H, Krauthgamer R, Berrebi A, Klein T, Nagler A, Tabilio A et al. Tolerance induction by megadose hematopoietic progenitor cells: expansion of veto cells by short-term culture of purified human CD34(+) cells. Blood 2002; 99: 4174–4181.

    CAS  PubMed  Google Scholar 

  24. Gur H, Krauthgamer R, Bachar-Lustig E, Katchman H, Arbel-Goren R, Berrebi A et al. Immune regulatory activity of CD34+ progenitor cells: evidence for a deletion-based mechanism mediated by TNF-alpha. Blood 2005; 105: 2585–2593.

    CAS  PubMed  Google Scholar 

  25. Terenzi A, Aristei C, Aversa F, Perruccio K, Chionne F, Raymondi C et al. Efficacy of fludarabine as an immunosuppressor for bone marrow transplantation conditioning: preliminary results. Transplant Proc 1996; 28: 3101.

    CAS  PubMed  Google Scholar 

  26. Aversa F, Tabilio A, Velardi A, Cunningham I, Terenzi A, Falzetti F et al. Treatment of high risk acute leukemia with T cell-depleted stem cells from related donors with one fully mismatched HLA haplotype. N Engl J Med 1998; 339: 1186–1193.

    CAS  PubMed  Google Scholar 

  27. Muller S, Schulz A, Reiss U, Schwarz K, Schreiner T, Wiesneth M et al. Definition of a critical T cell threshold for prevention of GVHD after HLA non-identical PBPC transplantation in children. Bone Marrow Transplant 1999; 24: 575–581.

    CAS  PubMed  Google Scholar 

  28. Russell JA, Turner AR, Larratt L, Chaudhry A, Morris D, Brown C et al. Adult recipients of matched related donor blood cell transplants given myeloablative regimens including pretransplant antithymocyte globulin have lower mortality related to graft-versus-host disease: a matched pair analysis. Biol Blood Marrow Transplant 2007; 13: 299–306.

    CAS  PubMed  Google Scholar 

  29. Waller EK, Langston AA, Lonial S, Cherry J, Somani J, Allen AJ et al. Pharmacokinetics and pharmacodynamics of anti-thymocyte globulin in recipients of partially HLA-matched blood hematopoietic progenitor cell transplantation. Biol Blood Marrow Transplant 2003; 9: 460–471.

    CAS  PubMed  Google Scholar 

  30. Aversa F, Terenzi A, Tabilio A, Falzetti F, Carotti A, Ballanti S et al. Full-haplotype mismatched hematopoietic stem cell transplantation: a phase II study in patients with acute leukemia at high risk or relapse. J Clin Oncol 2005; 23: 3447–3454.

    PubMed  Google Scholar 

  31. Meijer E, Slaper-Cortenbach IC, Thijsen SF, Dekker AW, Verdonck LF . Increased incidence of EBV-associated lymphoproliferative disorders after allogeneic stem cell transplantation from matched unrelated donors due to a change of T cell depletion technique. Bone Marrow Transplant 2002; 29: 335–339.

    CAS  PubMed  Google Scholar 

  32. Liu D, Tammik C, Zou JZ, Ernberg I, Masucci MG, Ringden O et al. Effect of combined T- and B-cell depletion of allogeneic HLA-mismatched bone marrow graft on the magnitude and kinetics of Epstein–Barr virus load in the peripheral blood of bone marrow transplant recipients. Clin Transplant 2004; 18: 518–524.

    PubMed  Google Scholar 

  33. Bonini C, Ciceri F, Lupo-Stanghellini MT, Bondanza A, Magnani Z, Penna SK et al. Rapid and effective immune reconstitution with HSV-TK engineered donor lymphocyte add-backs after haplo-HSCT. Bone Marrow Transplant 2006; 37 (Suppl 1): S23 (abstract O168).

    Google Scholar 

  34. Handgretinger R, Klingebiel T, Lang P, Schumm M, Neu S, Geiselhart A et al. Megadose transplantation of purified peripheral blood CD34(+) progenitor cells from HLAmismatched parental donors in children. Bone Marrow Transplant 2001; 27: 777–783.

    CAS  PubMed  Google Scholar 

  35. Barfield RC, Otto M, Houston J, Holladay M, Geiger T, Martin J et al. A one-step large-scale method for T and B-cell depletion of mobilized PBSC for allogeneic transplantation. Cytotherapy 2004; 6: 1–6.

    CAS  PubMed  Google Scholar 

  36. Chen X, Hale GA, Barfield R, Benaim E, Leung WH, Knowles J et al. Rapid immune reconstitution after a reduced-intensity conditioning regimen and a CD3-depleted haploidentical stem cell graft for paediatric refractory haematological malignancies. Br J Haematol 2006; 135: 524–532.

    PubMed  Google Scholar 

  37. Bethge WA, Faul C, Bornhauser M, Stuhler G, Lang P, Stelljes M et al. Haplo-identical allogeneic haematopoietic cell transplantation in adults after reduced-intensity conditioning with CD3/CD19-depleted graft. Bone Marrow Transplant 2007; 39 (Suppl 1): S178 (abstract P745).

    Google Scholar 

  38. Guinan EC, Boussiotis VA, Neuberg D, Neuberg D, LaVita Brennan L, Hirano N et al. Transplantation of anergic histoincompatible bone marrow allografts. N Engl J Med 1999; 340: 1704–1714.

    CAS  PubMed  Google Scholar 

  39. Guinan EC . Costimulatory blockade ex vivo: results of 2 pilot clinical trials. Blood Cell Mol Dis 2004; 33: 204–205.

    Google Scholar 

  40. Huang XJ, Liu DH, Liu KY, Xu LP, Chen H, Han W et al. Haploidentical hematopoietic stem cell transplantation without in vitro T cell depletion for the treatment of hematological malignancies. Bone Marrow Transplant 2006; 38: 291–297.

    PubMed  Google Scholar 

  41. Lu DP, Dong L, Wu T, Huang XJ, Zhang MJ, Han W et al. Conditioning including antithymocyte globulin followed by unmanipulated HLA-mismatched/haploidentical blood and marrow transplantation can achieve comparable outcomes with HLA-identical sibling transplantation. Blood 2006; 107: 3065–3073.

    CAS  PubMed  Google Scholar 

  42. Rizzieri DA, Koh LP, Long GD, Gasparetto C, Sullivan KM, Horwitz M et al. Partially matched, nonmyeloablative allogeneic transplantation: clinical outcomes and immune reconstitution. J Clin Oncol 2007; 25: 690–697.

    CAS  PubMed  Google Scholar 

  43. O'Donnell PV, Luznik L, Jones RJ, Vogelsang GB, Leffell MS, Phelps M et al. Nonmyeloablative bone marrow transplantation from partially HLA-mismatched related donors using posttransplantation cyclophosphamide. Biol Blood Marrow Transplant 2002; 8: 377–386.

    CAS  PubMed  Google Scholar 

  44. Molitor ML, Burlingham WJ . Immunobiology of exposure to non-inherited maternal antigens. Front Biosci 2007; 12: 3302–3311.

    CAS  PubMed  Google Scholar 

  45. van den Boogaardt DE, van Rood JJ, Roelen DL, Claas FH . The influence of inherited and noninherited parental antigens on outcome after transplantation. Transpl Int 2006; 19: 360–371.

    CAS  PubMed  Google Scholar 

  46. Ichinohe T, Teshima T, Matsuoka K, Maruya E, Saji H . Fetal-maternal microchimerism: impact on hematopoietic stem cell transplantation. Curr Opin Immunol 2005; 17: 546–552.

    CAS  PubMed  Google Scholar 

  47. van Rood JJ, Loberiza Jr FR, Zhang MJ, Oudshoorn M, Claas F, Cairo MS et al. Effect of tolerance to noninherited maternal antigens on the occurrence of graft-versus-host disease after bone marrow transplantation from a parent or an HLA-haploidentical sibling. Blood 2002; 99: 1572–1577.

    PubMed  Google Scholar 

  48. Narimatsu H, Morishita Y, Saito S, Shimada K, Ozeki K, Kohno A et al. Conditioning regimen of melphalan, fludarabine and total body irradiation in unmanipulated HLA haploidentical stem cell transplantation based on feto-maternal tolerance. Intern Med 2004; 43: 1063–1067.

    PubMed  Google Scholar 

  49. Obama K, Utsunomiya A, Takatsuka Y, Takemoto Y . Reduced-intensity non-T cell depleted HLA-haploidentical stem cell transplantation for older patients based on the concept of feto-maternal tolerance. Bone Marrow Transplant 2004; 34: 897–899.

    CAS  PubMed  Google Scholar 

  50. Marmont AM, Horowitz MM, Gale RP, Sobocinski K, Ash RC, van Bekkum DW et al. T cell depletion of HLA-identical transplants in leukemia. Blood 1991; 78: 2120–2130.

    CAS  PubMed  Google Scholar 

  51. Holler E . Risk assessment in haematopoietic stem cell transplantation: GvHD prevention and treatment. Best Pract Res Clin Haematol 2007; 20: 281–294.

    CAS  PubMed  Google Scholar 

  52. Ruggeri L, Mancusi A, Capanni M, Urbani E, Carotti A, Aloisi T et al. Donor natural killer cell allorecognition of missing self in haploidentical hematopoietic transplantation for acute myeloid leukemia: challenging its predictive value. Blood 2007; 110: 433–440.

    CAS  PubMed  PubMed Central  Google Scholar 

  53. Ruggeri L, Capanni M, Casucci M, Volpi I, Tosti A, Perruccio K et al. Role of natural killer cell alloreactivity in HLA-mismatched hematopoietic stem cell transplantation. Blood 1999; 94: 333–339.

    CAS  PubMed  Google Scholar 

  54. Ruggeri L, Mancusi A, Burchielli E, Aversa F, Martelli MF, Velardi A . Natural killer cell alloreactivity in allogeneic hematopoietic transplantation. Curr Opin Oncol 2007; 19: 142–147.

    PubMed  Google Scholar 

  55. Imai C, Iwamoto S, Campana D . Genetic modification of primary natural killer cells overcomes inhibitory signals and induces specific killing of leukemic cells. Blood 2005; 106: 376–383.

    CAS  PubMed  PubMed Central  Google Scholar 

  56. Leung W, Iyengar R, Turner V, Lang P, Bader P, Conn P et al. Determinants of antileukemia effects of allogeneic NK cells. J Immunol 2004; 172: 644–650.

    CAS  PubMed  Google Scholar 

  57. Boismenu R, Havran WL . An innate view of gamma delta T cells. Curr Opin Immunol 1997; 9: 57–63.

    CAS  PubMed  Google Scholar 

  58. Wilhelm M, Kunzmann V, Eckstein S, Reimer P, Weissinger F, Ruediger T et al. Gammadelta T cells for immune therapy of patients with lymphoid malignancies. Blood 2003; 102: 200–206.

    CAS  PubMed  Google Scholar 

  59. Godder KT, Henslee-Downey PJ, Mehta J, Park BS, Chiang KY, Abhyankar S et al. Long term disease-free survival in acute leukemia patients recovering with increased gammadelta T cells after partially mismatched related donor bone marrow transplantation. Bone Marrow Transplant 2007; 39: 751–757.

    CAS  PubMed  Google Scholar 

  60. Ochs L, Shu XO, Miller J, Enright H, Wagner J, Filipovich A et al. Late infections after allogeneic bone marrow transplantation: comparison of incidence in related and unrelated donor transplant recipients. Blood 1995; 86: 3979–3986.

    CAS  PubMed  Google Scholar 

  61. Dumont-Girard F, Roux E, van Lier RA, Hale G, Helg C, Chapuis B et al. Reconstitution of the T cell compartment after bone marrow transplantation: restoration of the repertoire by thymic emigrants. Blood 1998; 92: 4464–4471.

    CAS  PubMed  Google Scholar 

  62. Heitger A, Greinix H, Mannhalter C, Mayerl D, Kern H, Eder J et al. Requirement of residual thymus to restore normal T cell subsets after human allogeneic bone marrow transplantation. Transplantation 2000; 69: 2366–2373.

    CAS  PubMed  Google Scholar 

  63. Fujimaki K, Maruta A, Yoshida M, Kodama F, Matsuzaki M, Fujisawa S et al. Immune reconstitution assessed during five years after allogeneic bone marrow transplantation. Bone Marrow Transplant 2001; 27: 1275–1281.

    CAS  PubMed  Google Scholar 

  64. Volpi I, Perruccio K, Tosti A, Capanni M, Ruggeri L, Posati S et al. Post-grafting granulocyte colony-stimulating factor administration impairs functional immune recovery in recipients of HLA haplotype-mismatched hematopoietic transplants. Blood 2001; 97: 2514–2521.

    CAS  PubMed  Google Scholar 

  65. Perruccio K, Tosti A, Burchielli E, Topini F, Ruggeri L, Carotti A et al. Transferring functional immune responses to pathogens after haploidentical hematopoietic transplantation. Blood 2005; 106: 4397–4406.

    CAS  PubMed  PubMed Central  Google Scholar 

  66. Lucas KG, Small TN, Heller G, Dupont B, O'Reilly RJ . The development of cellular immunity to Epstein–Barr virus after allogeneic bone marrow transplantation. Blood 1996; 87: 2594–2603.

    CAS  PubMed  Google Scholar 

  67. Comoli P, Basso S, Zecca M, Pagliara D, Baldanti F, Bernardo ME et al. Preemptive therapy of EBV-related lymphoproliferative disease after pediatric haploidentical stem cell transplantation. Am J Transplant 2007; 7: 1648–1655.

    CAS  PubMed  Google Scholar 

  68. Marktel S, Magnani Z, Ciceri F, Cazzaniga S, Riddell SR, Traversari C et al. Immunologic potential of donor lymphocytes expressing a suicide gene for early immune reconstitution after hematopoietic T cell-depleted stem cell transplantation. Blood 2003; 101: 1290–1298.

    CAS  PubMed  Google Scholar 

  69. Ciceri F, Bonini C, Gallo-Stampino C, Bordignon C . Modulation of GvHD by suicide-gene transduced donor T lymphocytes: clinical applications in mismatched transplantation. Cytotherapy 2005; 7: 144–149.

    CAS  PubMed  Google Scholar 

  70. Traversari C, Marktel S, Magnani Z, Mangia P, Russo V, Ciceri F et al. The potential immunogenicity of the TK suicide gene does not prevent full clinical benefit associated with the use of TK-transduced donor lymphocytes in HSCT for hematologic malignancies. Blood 2007; 109: 4708–4715.

    CAS  PubMed  Google Scholar 

  71. Dey BR, Spitzer TR . Current status of haploidentical stem cell transplantation. Br J Haematol 2006; 135: 423–437.

    PubMed  Google Scholar 

  72. Velardi A, Ruggeri L, Moretta A, Moretta L . NK cells: a lesson from mismatched hematopoietic transplantation. Trends Immunol 2002; 23: 438–444.

    CAS  PubMed  Google Scholar 

  73. Zorn E . CD4+CD25+ regulatory T cells in human hematopoietic cell transplantation. Semin Cancer Biol 2006; 16: 150–159.

    CAS  PubMed  Google Scholar 

  74. Le Blanc K, Ringden O . Mesenchymal stem cells: properties and role in clinical bone marrow transplantation. Curr Opin Immunol 2006; 18: 586–591.

    CAS  PubMed  Google Scholar 

  75. Schattenberg AV, Dolstra H . Cellular adoptive immunotherapy after allogeneic stem cell transplantation. Curr Opin Oncol 2005; 17: 617–621.

    PubMed  Google Scholar 

  76. Peggs KS, Verfuerth S, Pizzey A, Khan N, Guiver M, Moss PA et al. Adoptive cellular therapy for early cytomegalovirus infection after allogeneic stem-cell transplantation with virus-specific T cell lines. Lancet 2003; 362: 1375–1377.

    PubMed  Google Scholar 

  77. Einsele H, Hebart H . CMV-specific immunotherapy. Hum Immunol 2004; 65: 558–564.

    CAS  PubMed  Google Scholar 

  78. Feuchtinger T, Matthes-Martin S, Richard C, Lion T, Fuhrer M, Hamprecht K et al. Safe adoptive transfer of virus-specific T cell immunity for the treatment of systemic adenovirus infection after allogeneic stem cell transplantation. Br J Haematol 2006; 134: 64–76.

    PubMed  Google Scholar 

  79. Thorne SH, Negrin RS, Contag CH . Synergistic antitumor effects of immune cell-viral biotherapy. Science 2006; 311: 1780–1784.

    CAS  PubMed  Google Scholar 

  80. Ottinger HD, Ferencik S, Beelen DW, Lindemann M, Peceny R, Elmaagacli AH et al. Hematopoietic stem cell transplantation: contrasting the outcome of transplantations from HLA-identical siblings, partially HLA-mismatched related donors, and HLA-matched unrelated donors. Blood 2003; 102: 1131–1137.

    CAS  PubMed  Google Scholar 

  81. Yakoub-Agha I, Mesnil F, Kuentz M, Boiron JM, Ifrah N, Milpied N et al. Allogeneic marrow stem-cell transplantation from human leukocyte antigen-identical siblings versus human leukocyte antigen-allelic-matched unrelated donors (10/10) in patients with standard-risk hematologic malignancy: a prospective study from the French Society of Bone Marrow Transplantation and Cell Therapy. J Clin Oncol 2006; 24: 5695–5702.

    PubMed  Google Scholar 

  82. Cesaro S . Role and cost efficacy of unrelated cord blood in adult hematopoietic syem transplantation. Bone Marrow Transplant 2005; 36: 275.

    CAS  PubMed  Google Scholar 

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Acknowledgements

I thank all the laboratory and technical staff, the attending physicians and nurses of the HSCT Unit at the University of Perugia, Italy, for their dedication and professional skills. Special thanks to Professor Massimo F Martelli for pioneering the mismatched transplant, Professor Yair Reisner for his expertise in transplant biology and Dr Geraldine Boyd for his help in writing this paper.

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  1. Haematopoietic Stem Cell Transplant Unit, Section of Haematology and Immunology, IBIT Foundation, University of Perugia, Perugia, Italy

    F Aversa

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Aversa, F. Haploidentical haematopoietic stem cell transplantation for acute leukaemia in adults: experience in Europe and the United States. Bone Marrow Transplant 41, 473–481 (2008). https://doi.org/10.1038/sj.bmt.1705966

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