How we perform haploidentical stem cell transplantation with posttransplant cyclophosphamide

Area of Science:

• Hematology
• Immunology
• Transplantation Medicine

Background:

• Human Leukocyte Antigen (HLA)-haploidentical hematopoietic stem cell transplantation (HSCT) is a widely adopted alternative donor strategy.
• T-cell-replete strategies, particularly those utilizing high-dose posttransplant cyclophosphamide, are prevalent.
• This method bypasses the need for graft manipulation and storage, reducing acquisition costs.

Observation:

• The use of posttransplant cyclophosphamide in HLA-haploidentical HSCT is linked to reduced rates of severe graft-versus-host disease and nonrelapse mortality.
• This transplantation strategy exhibits significant safety in older patients (up to 75 years) when combined with reduced-intensity conditioning.
• Outcomes in older patients receiving this treatment are comparable to those in younger patient cohorts.

Findings:

• Registry-based studies validate the efficacy of HLA-haploidentical HSCT with posttransplant cyclophosphamide.
• The effectiveness of this approach rivals that of HLA-matched HSCT.
• The described platform is characterized by rapid availability and clinical simplicity.

Implications:

• HLA-haploidentical HSCT with posttransplant cyclophosphamide represents a readily accessible and safe transplantation option.
• This method expands the donor pool for patients requiring HSCT.
• Further clinical investigation into this platform can optimize its application and patient outcomes.