TY - JOUR
T1 - Haploidentical hematopoietic stem cell transplant
T2 - How to choose the best donor? Guidelines from the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC)
AU - Dubois, Valérie
AU - Amokrane, Kahina
AU - Beguin, Yves
AU - Bruno, Bénédicte
AU - Chevallier, Patrice
AU - Delbos, Florent
AU - Devillier, Raynier
AU - Giannoli, Catherine
AU - Guidicelli, Gwendaline
AU - Harif, Mhamed
AU - Loiseau, Pascale
AU - Rouzaire, Paul Olivier
AU - Varlet, Pauline
AU - Yakoub-Agha, Ibrahim
AU - Nguyen, Stéphanie
N1 - Publisher Copyright:
© 2019
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Haploidentical hematopoietic stem cell transplantation has been growing steadily since 2012. The SFGM-TC has twice published guidelines concerning T-cell repleted haploidentical grafts with high dose cyclophosphamide post-transplantation. The 2013 workshop recommended using the non-myeloablative Baltimore protocol with bone marrow and developed prospective protocols to evaluate these transplantations. The 2015 workshop reported improved results of reduced conditioning regimens in Hodgkin's lymphoma and intensive conditioning in myeloid hemopathies, and a similar outcome with 10/10 HLA matched donor with the same disease-risk score thus raising the question of the qualifier “alternative” for haploidentical transplants. The current work concerns the criteria for selecting the donor. The main criterion remains the absence of anti-HLA antibodies directed against the donor present in the recipient sera (DSA – Donor Specific Antibodies). In case of DSA and in the absence of an alternative donor, desensitization protocols exist. The other criteria are impossible to prioritize: age, sex, CMV, and blood type. The degree of relatedness and the number of HLA incompatibilities do not seem to be a criterion of choice. The ‘ideal’ donor would be a young man, CMV-matched, without major ABO incompatibility with a marrow transplant. There is insufficient data for the KIR-ligand and NIMA/NIPA mismatch. Peripheral stem cell grafts appear to yield more acute GVHD than bone marrow grafts after intensive conditioning, but with comparable survival rates. Based on the literature review, the comparison of haploidentical with unrelated donors encourages inclusion in existing national protocols randomizing these different donors.
AB - Haploidentical hematopoietic stem cell transplantation has been growing steadily since 2012. The SFGM-TC has twice published guidelines concerning T-cell repleted haploidentical grafts with high dose cyclophosphamide post-transplantation. The 2013 workshop recommended using the non-myeloablative Baltimore protocol with bone marrow and developed prospective protocols to evaluate these transplantations. The 2015 workshop reported improved results of reduced conditioning regimens in Hodgkin's lymphoma and intensive conditioning in myeloid hemopathies, and a similar outcome with 10/10 HLA matched donor with the same disease-risk score thus raising the question of the qualifier “alternative” for haploidentical transplants. The current work concerns the criteria for selecting the donor. The main criterion remains the absence of anti-HLA antibodies directed against the donor present in the recipient sera (DSA – Donor Specific Antibodies). In case of DSA and in the absence of an alternative donor, desensitization protocols exist. The other criteria are impossible to prioritize: age, sex, CMV, and blood type. The degree of relatedness and the number of HLA incompatibilities do not seem to be a criterion of choice. The ‘ideal’ donor would be a young man, CMV-matched, without major ABO incompatibility with a marrow transplant. There is insufficient data for the KIR-ligand and NIMA/NIPA mismatch. Peripheral stem cell grafts appear to yield more acute GVHD than bone marrow grafts after intensive conditioning, but with comparable survival rates. Based on the literature review, the comparison of haploidentical with unrelated donors encourages inclusion in existing national protocols randomizing these different donors.
KW - Donor choice
KW - DSA
KW - Haploidentical transplantation
UR - http://www.scopus.com/inward/record.url?scp=85072748882&partnerID=8YFLogxK
U2 - 10.1016/j.bulcan.2019.07.011
DO - 10.1016/j.bulcan.2019.07.011
M3 - Review article
C2 - 31586527
AN - SCOPUS:85072748882
SN - 0007-4551
VL - 107
SP - S72-S84
JO - Bulletin du Cancer
JF - Bulletin du Cancer
IS - 1
ER -