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World J Transplant. Dec 24, 2016; 6(4): 665-674
Published online Dec 24, 2016. doi: 10.5500/wjt.v6.i4.665
Overview of the progress on haploidentical hematopoietic transplantation
Nosha Farhadfar, William J Hogan
Nosha Farhadfar, William J Hogan, Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, United States
Author contributions: All authors contributed to drafting, revision and final approval of the article.
Conflict-of-interest statement: The authors declare no conflicts of interest regarding this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: William J Hogan, MBBCh, MRCPI, Division of Hematology, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States. hogan.william@mayo.edu
Telephone: +1-507-2842017 Fax: +1-507-2664972
Received: July 19, 2016
Peer-review started: July 21, 2016
First decision: September 5, 2016
Revised: September 28, 2016
Accepted: October 22, 2016
Article in press: October 24, 2016
Published online: December 24, 2016
Abstract

Allogeneic hematopoietic stem cell transplant (HSCT) remains the only potentially curative option for variety of hematologic disorders. Lack of a suitable fully HLA-matched donor limits this option for many patients. Without a suitable related or unrelated HLA-matched donor, umbilical cord blood and haploidentical family members provide a potential source of stem cells. Timely donor availability makes haploidentical donors an attractive alternative donor source. Initial attempts at haploidentical HSCT was associated with significantly increased mortality owing to high rates of graft rejection and severe graft-versus-host disease caused by major donor-recipient HLA-disparity. However, over the past decade, outcomes of haploidentical HSCT have improved significantly. Here, we review the advantages and challenges of haploidentical transplantation. We also discuss new developments to attempt to overcome the challenges to a successful haploidentical transplantation.

Keywords: Haploidentical donor, Hematopoietic stem cell transplantation, Hematological malignancies, Transplant related mortality

Core tip: Over the past decade, haploidentical donors have emerged as a viable alternate graft source for patients without a HLA-matched donor. Several strategies including graft manipulation, conditioning regimen optimization and better graft-versus-host disease control have significantly improved the outcomes of haploidentical hematopoietic stem cell transplant (HSCT). Here, we summarize some of the recent advances in the field of haploidentical HSCT in adults.