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Detection of Residual Donor Erythroid Progenitor Cells after Hematopoietic Stem Cell Transplantation for Patients with Hemoglobinopathies
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Donor selection in T cell-replete haploidentical hematopoietic stem cell transplantation: knowns, unknowns, and

Stefan O Ciurea1, Richard E Champlin

  • 1University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA. sciurea@mdanderson.org

Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation
|August 16, 2012
PubMed

Multiple donors are generally available for haploidentical hematopoietic stem cell transplantation. Here we discuss the factors that should be considered when selecting donors for this type of transplantation according to the currently available evidence. Donor-specific anti-HLA antibodies (DSAs) increase the risk of graft failure and should be avoided whenever possible. Strategies to manage recipients with DSAs are discussed. One should choose a full haplotype mismatch rather than a better-matched donor and maximize the dose of infused hematopoietic cells. Donor age and sex are other important factors. Other factors, including predicted natural killer cell alloreactivity and consideration of noninherited maternal alleles, are more controversial. Larger studies are needed to further clarify the role of these factors for donor selection in haploidentical hematopoietic stem cell transplantation.

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