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Current Stem Cell Research & Therapy


ISSN (Print): 1574-888X
ISSN (Online): 2212-3946

Hematopoietic Stem Cell Transplantation from Alternative Donors for High-Risk Acute Leukemia: The Haploidentical Option

Author(s): Franco Aversa, Antonio Tabilio, Andrea Velardi, Adelmo Terenzi, Franca Falzetti, Alessandra Carotti, Teresa Aloisi, Maria Liga, Mauro Di Ianni, Tiziana Zei, Antonella Santucci and Massimo F. Martelli

Volume 2, Issue 1, 2007

Page: [105 - 112] Pages: 8

DOI: 10.2174/157488807779316973

Price: $65


Much progress has been made in the clinical, biological and technical aspects of the T-cell-depleted full-haplotype mismatched transplants for acute leukemia. Our experience demonstrates that infusing a megadose of extensively T-cell-depleted hematopoietic peripheral blood stem cells after an immunomyeloablative conditioning regimen in acute leukemia patients ensures sustained engraftment with minimal graft-vs-host disease (GvHD) without the need of any post-transplant immunosuppressive treatment. Since our first successful pilot study, our efforts have concentrated on developing new conditioning regimens, optimizing the graft processing and improving the post-transplant immunological recovery. The results we have so far achieved in more than 200 high-risk acute leukemia patients show that haploidentical transplantation is now a clinical reality. Because virtually all patients in need of a hematopoietic stem cell transplant have a full-haplotype mismatched donor, who is immediately available, a T-cell depleted mismatched transplant should be offered, not as a last resort, but as a viable option to high risk acute leukemia patients who do not have, or cannot find, a matched donor.

Keywords: Haploidentical transplantation, high-risk acute leukemia, T-cell depletion, NK cell alloreactivity

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