The rationale behind grafting haploidentical hematopoietic stem cells

The ability to perform hematopoietic cell transplant across major histocompatibility complex barriers can dramatically increase the availability of donors and allow more patients across the world to pursue curative transplant procedures for underlying hematologic disorders. Early attempts at haploid...

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Main Authors: Richard T. Maziarz, Rachel J. Cook
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Hematology
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/16078454.2024.2347673
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author Richard T. Maziarz
Rachel J. Cook
author_facet Richard T. Maziarz
Rachel J. Cook
author_sort Richard T. Maziarz
collection DOAJ
description The ability to perform hematopoietic cell transplant across major histocompatibility complex barriers can dramatically increase the availability of donors and allow more patients across the world to pursue curative transplant procedures for underlying hematologic disorders. Early attempts at haploidentical transplantation using broadly reactive T-cell depletion approaches were compromised by graft rejection, graft-versus-host disease and prolonged immune deficiency. The evolution of haploidentical transplantation focused on expanding transplanted hematopoietic progenitors as well as using less broadly reactive T-cell depletion. Significant outcome improvements were identified with technology advances allowing selective depletion of donor allospecific T cells, initially ex-vivo with evolution to its current in-vivo approach with the infusion of the highly immunosuppressive chemotherapy agent, cyclophosphamide after transplantation procedure. Current approaches are facile and portable, allowing expansion of allogeneic hematopoietic cell transplantation for patients across the world, including previously underserved populations.
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spelling doaj-art-d4e737183a0145b4862819f0362616cf2025-08-20T02:50:19ZengTaylor & Francis GroupHematology1607-84542024-12-0129110.1080/16078454.2024.2347673The rationale behind grafting haploidentical hematopoietic stem cellsRichard T. Maziarz0Rachel J. Cook1Center for Hematologic Malignancies, Division of Hematology & Medical Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USACenter for Hematologic Malignancies, Division of Hematology & Medical Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USAThe ability to perform hematopoietic cell transplant across major histocompatibility complex barriers can dramatically increase the availability of donors and allow more patients across the world to pursue curative transplant procedures for underlying hematologic disorders. Early attempts at haploidentical transplantation using broadly reactive T-cell depletion approaches were compromised by graft rejection, graft-versus-host disease and prolonged immune deficiency. The evolution of haploidentical transplantation focused on expanding transplanted hematopoietic progenitors as well as using less broadly reactive T-cell depletion. Significant outcome improvements were identified with technology advances allowing selective depletion of donor allospecific T cells, initially ex-vivo with evolution to its current in-vivo approach with the infusion of the highly immunosuppressive chemotherapy agent, cyclophosphamide after transplantation procedure. Current approaches are facile and portable, allowing expansion of allogeneic hematopoietic cell transplantation for patients across the world, including previously underserved populations.https://www.tandfonline.com/doi/10.1080/16078454.2024.2347673Haploidentical transplantationHLA mismatchgraft vs host diseasegraft rejection
spellingShingle Richard T. Maziarz
Rachel J. Cook
The rationale behind grafting haploidentical hematopoietic stem cells
Hematology
Haploidentical transplantation
HLA mismatch
graft vs host disease
graft rejection
title The rationale behind grafting haploidentical hematopoietic stem cells
title_full The rationale behind grafting haploidentical hematopoietic stem cells
title_fullStr The rationale behind grafting haploidentical hematopoietic stem cells
title_full_unstemmed The rationale behind grafting haploidentical hematopoietic stem cells
title_short The rationale behind grafting haploidentical hematopoietic stem cells
title_sort rationale behind grafting haploidentical hematopoietic stem cells
topic Haploidentical transplantation
HLA mismatch
graft vs host disease
graft rejection
url https://www.tandfonline.com/doi/10.1080/16078454.2024.2347673
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