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A perfect mismatch: haploidentical hematopoietic stem cell transplantation overtakes a bend

Cellular & Molecular Immunology (2023)Cite this article

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Matching for the major histocompatibility complex (MHC)—and more specifically, the human leukocyte antigen (HLA) system—has been the gold standard in transplantation for decades. Selecting an HLA-matched donor is the preferred and straightforward choice for most immunologists, hematologists, and organ transplant specialists. Conversely, HLA-mismatched donors have been less accepted in hematopoietic stem cell transplantation (HSCT) due to unacceptable severe graft-versus-host disease (GvHD) and/or host-versus-graft (HvG) rejection. However, in the past three decades, a new approach has emerged: haploidentical HSCT (haplo-HSCT), which uses a related donor who is only partially matched to the recipient, such as parents and offspring. This new treatment has been shown to have similar or even better outcomes than classical HSCT of HLA-identical sibling donors (MSDs). Haploidentical donors have become a significant donor source for stem cell transplantation around the world in the past decade, and they now account for more than 60% of all donors in China and ~20% of donors in Europe and North America [1, 2]. This has led many to question whether mismatch could lead to better transplantation outcomes, and if so, for whom, how, and why?

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Acknowledgements

National Key Research and Development Program of China (No.2022YFA1103300, 2021YFA1100902); Major Program, Key Program and General Program of the National Natural Science Foundation of China (82293630, 81930004, 82070182); Beijing Nova Program of Science and Technology (No. Z191100001119120); Fund of China Scholarship Council (202106015007).

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  1. These authors contributed equally: Meng Lv, Hui-Dong Guo.

Authors and Affiliations

  1. Peking University People’s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China

    Meng Lv, Hui-Dong Guo & Xiao-jun Huang

  2. Peking-Tsinghua Center for Life Sciences, Beijing, China

    Xiao-jun Huang

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  1. Meng Lv
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  2. Hui-Dong Guo
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XJH designed the comment. ML and HDG drafted the manuscript and prepared the figures. All authors read and approved the final manuscript.

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Correspondence to Xiao-jun Huang.

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Lv, M., Guo, HD. & Huang, Xj. A perfect mismatch: haploidentical hematopoietic stem cell transplantation overtakes a bend. Cell Mol Immunol (2023). https://doi.org/10.1038/s41423-023-01007-y

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