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a Children's University Hospital, University of Tuebingen, Tuebingen, Germany b St. Jude Children's Research Hospital, Memphis, Tennessee, USA
Key Words: haploidentical transplantation • reduced intensity conditioning • T cell depletion
Address for correspondence: Rupert Handgretinger, M.D., Children's University Hospital, University of Tuebingen, Hoppe-Seyler-Strasse 1, 72076 Tuebingen, Germany. Voice: 49-7071-298-4744; fax: 49-7071-294-713. Rupert.Handgretinger{at}med.uni-tuebingen.de
Allogeneic stem cell transplantation is for a number of patients with malignant and nonmalignant diseases the only curative approach. For those patients who do not have an HLA-identical–related or –unrelated stem cell donor, a related three-loci mismatch haploidentical stem cell transplantation with T cell-depleted stem cells is a viable option. T cell depletion either by CD34+ positive selection or by CD3-negative depletion strategies is available and has been investigated. We have shown that reduced-intensity conditioning haploidentical transplantation using mobilized peripheral stem cells negatively depleted from T and B lymphocytes is associated with a rapid immune reconstitution, a low transplant-related mortality rate, and a favorable outcome in patients in remission at the time of transplant. For chemorefractory patients, additional posttransplant cellular and humoral immunotherapeutic strategies are needed for prevention of relapse after transplantation.
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