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Bone Marrow Transplant. 2019 Mar 4. doi: 10.1038/s41409-019-0499-z. [Epub ahead of print]

The European Society for Blood and Marrow Transplantation (EBMT) consensus recommendations for donor selection in haploidentical hematopoietic cell transplantation.

Author information

1
The University of Texas MD Anderson Cancer Center, Houston, TX, USA. sciurea@mdanderson.org.
2
Department of Hematology and HCT, City of Hope National Medical Center, Duarte, CA, USA.
3
Department of Medicine, Thammasat University, Pathumthani, Thailand.
4
Division of Hematologic Malignancies, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA.
5
Institute of Hematology, Peking University People's Hospital, Beijing, China.
6
Hematology and BMT Unit, San Raffaele Scientific Institute, Milan, Italy.
7
Department of Pediatric Hematology and Oncology, IRCCS Ospedale Pediatrico Bambino Gesu, University La Sapienza, Rome, Italy.
8
Hematology and BMT Unit, University of Parma, Parma, Italy.
9
Hematology Department, Humanitas Clinical and Research Center, Milan, Italy.
10
Instituto di Ematologia, Fondazione Policlinico Universitario Gemelli, IRCCS, Universita' Cattolica del Sacro Cuore, Roma, Italy.
11
University of Perugia, Perugia, Italy.
12
Departement D'Hematologie, Programme de Transplantation et de Therapie Cellulaire, Aix Marseille Univ, Inserm, CNRS, CRCM, Marseille, France.
13
Departement de Psychologie Clinique, Institut Paoli Calmettes, Marseille, France.
14
Department of Hematology and Oncology, Children's University Hospital, Tubingen, Germany.
15
Blood and Marrow Transplantation Program, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, QC, Canada.
16
Massachusetts General Hospital Cancer Center, Boston, MA, USA.
17
BMT Program at Northside Hospital, Atlanta, GA, USA.
18
Dana Farber Cancer Institute, Boston, MA, USA.
19
Facultad de Medicina Universidad Complutense, HGU Gregorio Maranon, Madrid, Spain.
20
Case Western Reserve University, Cleveland, OH, USA.
21
University of Virginia Health System, Charlottesville, VA, USA.
22
Vanderbilt University Medical Center, Nashville, TN, USA.
23
Hopital Saint-Antoine, Paris, France.
24
Acute Leukemia Working Party of the EBMT, Hopital Saint-Antoine, Paris, France.
25
Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel.

Abstract

The number of HLA-haploidentical hematopoietic cell transplants continues to increase worldwide due to recent improvements in outcomes, allowing more patients with hematological malignancies and non-malignant disorders to benefit from this procedure and have a chance to cure their disease. Despite these encouraging results, questions remain as multiple donors are usually available for transplantation, and choosing the best HLA-haploidentical donor for transplantation remains a challenge. Several approaches to haploidentical transplantation have been developed over time and, based on the graft received, can be grouped as follows: T-cell depleted haploidentical transplants, either complete or partial, or with T-cell replete grafts, performed with post-transplant cyclophosphamide-based graft-versus-host disease (GVHD) prophylaxis, or G-CSF-primed bone marrow graft and enhanced GVHD prophylaxis. Carefully selecting the donor can help optimize transplant outcomes for recipients of haploidentical donor transplants. Variables usually considered in the donor selection include presence of donor-specific antibodies in the recipient, donor age, donor/recipient gender and ABO combinations, and immunogenic variables, such as natural killer cell alloreactivity or KIR haplotype. Here we provide a comprehensive review of available evidence for selecting haploidentical donors for transplantation, and summarize the recommendations from the European Society for Blood and Marrow Transplantation (EBMT) on donor selection for different transplant platforms.

PMID:
30833742
DOI:
10.1038/s41409-019-0499-z

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