Review
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Stem Cells. Sep 26, 2014; 6(4): 380-390
Published online Sep 26, 2014. doi: 10.4252/wjsc.v6.i4.380
Advances in haplo-identical stem cell transplantation in adults with high-risk hematological malignancies
Michael J Ricci, Jeffrey A Medin, Ronan S Foley
Michael J Ricci, Ronan S Foley, Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario L8V 1C3, Canada
Jeffrey A Medin, University Health Network, Toronto, Ontario M5G 2M1, Canada
Ronan S Foley, Juravinski Hospital and Cancer Center, 711 Concession Street, Hamilton, Ontario L8V 1C3, Canada
Author contributions: Ricci MJ and Foley RS completed the literature search and review of current clinical transplant trials; Medin JA oversaw the write up and provided input on the stem cell and immune background.
Correspondence to: Ronan S Foley, MD, FRCPC, Associate Professor, Juravinski Hospital and Cancer Center, 711 Concession Street, Hamilton, Ontario L8V 1C3, Canada. foleyr@hhsc.ca
Telephone: +1-905-5212100-42074 Fax: +1-905-5752553
Received: November 28, 2013
Revised: July 4, 2010
Accepted: July 15, 2014
Published online: September 26, 2014
Abstract

Allogeneic bone marrow transplant is a life-saving procedure for adults and children that have high-risk or relapsed hematological malignancies. Incremental advances in the procedure, as well as expanded sources of donor hematopoietic cell grafts have significantly improved overall rates of success. Yet, the outcomes for patients for whom suitable donors cannot be found remain a significant limitation. These patients may benefit from a hematopoietic cell transplant wherein a relative donor is fully haplotype mismatched. Previously this procedure was limited by graft rejection, lethal graft-versus-host disease, and increased treatment-related toxicity. Recent approaches in haplo-identical transplantation have demonstrated significantly improved outcomes. Based on years of incremental pre-clinical research into this unique form of bone marrow transplant, a range of approaches have now been studied in patients in relatively large phase II trials that will be summarized in this review.

Keywords: Peripheral blood progenitors, Stem cell transplantation, Graft-versus-host disease, Haplo-identical donor, Hematological malignancies

Core tip: Timely donor availability remains a challenge for patients in need of an urgent stem cell transplant. The ability to obtain half matched stem cells from any family member represents a significant breakthrough in the field. This review summarizes some of the current strategies used to substantially improve the outcomes of patients undergoing haplo-identical stem cell transplantation.