E-Book

E-Book 2nd Congress

  • Haploidentical Hematopoietic stem cell transplantation, when and how?
  • Hamid Farajifard,1,* Amir Ali Hamidiyeh,2
    1. TUMS
    2. TUMS


  • Introduction: hematologic and non-hematologic diseases. first of in HSCT, patients need HLA full-match donor for HLA-*A, *B, *C, *DRb1, *DQB1, *DPb1 loci as most polymorphic loci in humankind. Any patients have 30 percent chance to find full-match donor in family. In recent years, by development and progress of donor registry bank, patients’ chance increased by 70 percent by use of about 40 million unrelated donors. With all this, significant percentage patients can’t find full-match donor and because of urgent HSCT and probability of relapse in malignant patients or severe infection, there is no any other choice except haploidentical HSCT that leukemia patients are more at risk. Any kind of HSCTs act as double-edged sword, rejection and GvHD might be happen and those probabilities are more likely in haploidentical HSCT. So choosing the right haploidentical donor will be avoid patients’ complication after HSCT.
  • Methods: Immunosuppression prophylaxis drugs prepare environmental condition to prevent severe acute GvHD in haploidentical HSCT patients. So immune reconstitution after HSCT must be determined. By now two protocols of haploidentical HSCT contain T Cell Replete (TCR) and T Cell Deplete (TCD) has been defined that both have own cost and benefit. In TCR protocol patients need younger, sex match, ABO match, NIMA mismatch donor and no donor specific antibody in patients. In TCR, the GvHD will be more likely to happen. In TCD protocol, KIR matching is needed. younger, sex match, ABO match, NIMA mismatch donor is preferred and donor specific antibody in patients must be ruled out. More rejection in TCD protocol is expected.
  • Results: Haplo identical HSCT compare to unrelated one locus mismatch shown lower transplanted related mortality and increased of overall survival.
  • Conclusion: batter matching in HLA and KIR can improve Haplo identical HSCT out come and it will be solution for patients with no HLA full-match donor.
  • Keywords: Haplo identical HSCT - HLA matching -