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Bull Cancer. 2016 Nov;103(11S):S229-S242. doi: 10.1016/j.bulcan.2016.09.007. Epub 2016 Nov 11.

[Haploidentical hematopoietic stem cell transplantation: Guidelines from the Francophone society of marrow transplantation and cellular therapy (SFGM-TC)].

[Article in French]

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Groupe hospitalier Pitié-Salpêtrière, service d'hématologie, 83-89, boulevard de l'Hôpital, 75013 Paris, France. Electronic address:
Hôpitaux universitaire Genève (HUG), faculté de médecine, service d'hématologie, rue Gabrielle-Perret-Gentil 4, 1211 Genève 4, Suisse.
Centre de thérapie cellulaire, institut Paoli-Calmettes, 232, boulevard de Ste-Marguerite, 13009 Marseille, France; Centre d'investigations cliniques en biothérapie, CBT-1409, 13009 Marseille, France.
EFS Alpes Méditerranée, laboratoire d'histocompatibilité, 149, boulevard Baille, 13001 Marseille, France.
EFS Rhône Alpes Grenoble, laboratoire d'histocompatibilité, 29, avenue Maquis-du-Grésivaudan, 38701 La Tronche, France.
Hôpital Saint-Louis, unité hématologie adolescents jeunes adultes, 1, avenue Claude-Vellefaux, 75010 Paris, France.
Hôpital universitaire Necker-Enfants malades, AP-HP, service d'hématologie adulte, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, institut Imagine, Paris Sorbonne Cité, Inserm U1163, CNRS ERL 8254, 75015 Paris, France.
CHU St.-Eloi, coordination de la greffe, 80, avenue Augustin-Fliche, 34090 Montpellier, France.
CHU groupe hospitalier Sud, hématologie clinique, D408, 80054 Amiens, France.
Établissement hospitalier et universitaire 1(er)-Novembre-1954, service d'hématologie et de thérapie cellulaire, BP 4166, 31000 Ibn Rochd, Oran, Algérie; Université d'Oran 1, Ahmed Ben Bella, faculté de médecine, Oran, Algérie.
CHU d'Angers, maladies du sang, rue Larrey, 49000 Angers, France.
Hôpital Saint-Antoine, service d'hématologie clinique et thérapie cellulaire, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France; Université Pierre-et-Marie-Curie, UMRs 938 Inserm, 75006 Paris, France.
Institut Paoli-Calmette, unité de greffe, 232, boulevard de Sainte-Marguerite, 13009 Marseille, France.
CHU de Lille, maladies du sang, hématologie, 2, avenue Oscar-Lambret, 59000 Lille, France; Faculté de médecine, université Lille 2, LIRIC, Inserm U995, place Verdun, 59045 Lille, France.
Hôpital Brabois, service d'hématologie et de médecine interne, rue du Morvan, 54500 Vandœuvre-les-Nancy, France; CHRU Nancy, université de Lorraine, CNRS UMR 7365, 54500 Vandœuvre-les-Nancy, France.


Haploidentical hematopoietic stem cell transplantation (HSCT) is being increasingly used due to improvement of the transplantation procedures allowing a reduction of graft-versus-host-disease (GVHD) and of transplant-related mortality (TRM). Such improvements have been particularly observed after administration of T-replete HSCT graft associated to an in vivo T cell depletion by the administration of high-doses of cyclophosphamide (HD-Cy) after transplantation. Here, we have analyzed the results of haplo-identical T replete HSC transplants, in particular, when performed with post-transplant HD-Cy in order to provide recommendations for the clinical practice. Criteria of choice for a haploidentical donor by priority order are absence of donor-specific antibodies (DSA) and to prioritize: CMV seronegative recipient/donor couples, ABO matching in case of deserythrocytation, male donor for a male recipient, the youngest donor. There is no clear argument in favor of the use of bone marrow versus peripheral blood stem cells (PBSC) after non myeloablative conditioning regimen, while after ablative conditioning PBSC seem to be associated with higher risks of GVHD without obvious impact on survival. Results of haploidentical HSCT, confirmed by several groups, are interesting in lymphomas (in particular Hodgkin disease) and for acute leukemia. Outcomes of patients rely on age, disease status at transplant and conditioning intensity. At equivalent disease risk, results of haploidentical HSCT seem comparable to those of HLA matched HSCT, raising the question of the classification of such transplants as alternatives. In all cases, we recommend to include patients in prospective clinical trials.


Choice of donor; Choix du donneur; Conditioning regimens and indications; Conditionnements et indications; Donneur haplo-identique; Greffe de cellules-souches hématopoïétiques; Haploidentical donor; Hematopoietic stem cell transplantation; Type de greffon; Type of stem cell graft

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