Allogeneic transplantation across the HLA barriers |
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Authors: | Aversa F Tabilio A Velardi A Martelli M F |
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Institution: | Hematopoietic Stem Cell Transplant Program, Section of Hematology and Clinical Immunology, University of Perugia, Perugia, Italy. aversa@unipg.it |
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Abstract: | In high-risk acute leukemia patients, a 10-fold increase in the dose of extensively T-cell-depleted hematopoietic stem cells ensures sustained full-donor engraftment of one-haplotype-mismatched transplants without graft-vs.-host disease. Since our first successful pilot study, which exploited the principle of a megadose stem cell transplant, our efforts have concentrated on developing new conditioning regimens, optimizing graft processing and improving the post-transplant immunologic recovery. The results so far achieved in more than 100 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 family donor, a T-cell-depleted mismatched transplant can be offered with curative intent, thus extending allogeneic transplantation procedures to virtually all candidates. |
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