ABSTRACT
Hematopoietic stem cell transplantation (HSCT) is the only effective curative therapy for patients with certain hematological diseases. Haploidentical HSCT has been practiced worldwide for approximately twenty years. Significant improvements on this therapy were made in China within the past decade, with the novel non-in-vitro, T-cell-depleted haploidentical HSCT system. This review de-scribes the current situation and provides a prospective overview of these novel HSCT systems in China.
ABSTRACT
Objective To investigate the influences of HLA mismatching on renal function in the kidney transplant patients re-ceiving pairs of allograft from the same donor.Methods 171 pairs of renal transplant patients receiving the kidneys from the same donors were investigated.They were admitted in our hospital before 2008.Their human leukocyte antigens (HLA)were typed with the commercial polymerase chain reaction (PCR)-sequence-specific primers (SSP)HLA typing kit (One Lambda,Inc.,USA;and GTI Diagnostics,USA).The serum creatinine (SCr)and blood urea nitrogen(BUN)were measured in the clinical laboratory of our hospital.Results Among 171 pairs of renal transplant patients,there were 162 recipients with HLA mismatch≤4,in which the re-nal function was remained stable in 107 recipients and lost or decreased in 55 patients.There were 180 recipients with HLA mis-match >4,in which the renal function was stayed normal in 84 recipients and lost or decreased in 96 patients.The difference in in-fluencing the renal function between the HLA mismatch≤4 and HLA mismatch>4 had statistical significance (χ2 =12.22,P <0.05).Conclusion Excellent HLA typing match has important significance for renal long term survival.
ABSTRACT
Much of the success of hematopoietic stem cell transplantation (HSCT) has been due to the ability to overcome posttransplant complications, by performing HLA genotypically matched or even mismatched sibling donor HSCT or unrelated donor HSCT. Based on the promising results with using vigorously T-cell-depleted high-dose peripheral blood stem cell transplants by the Perugia University group, several methods to eradicate refractory leukemic cells have been employed worldwide. However, there are limitations of the existing data regarding haploidentical HSCT, that is, the small numbers of patients and the heterogeneous patient populations in most of the published series. Also, researchers have not exactly demonstrated the effect of natural killer (NK) cell alloreactivity in various settings of allogeneic HSCT. In reality, haploidentical HSCT is possible without T-cell depletion. However, it isn't clear whether reduced-intensity HSCT from a haploidentical related donor or a mismatched unrelated donor is feasible. Anyhow, successfully overcoming the major histocompatibility barriers with using related or unrelated donors means that virtually all patients would have an immediately available donor for desperately needed HSCT. The full potential of haploidentical HSCT may be ultimately achieved through a better understanding of the transplant immunology, including the Korean specificity of killer cell immunoglobulin-like receptor polymorphism. Further study and better support from Korean government insurance coverage that would offer HSCT to more patients in need of transplant and cultivating an optimal NK alloreaction without detrimental complications is urgently required.
Subject(s)
Humans , Allergy and Immunology , Hematopoietic Stem Cell Transplantation , Hematopoietic Stem Cells , Histocompatibility , Insurance Coverage , Receptors, KIR , Sensitivity and Specificity , Siblings , Stem Cells , T-Lymphocytes , Tissue Donors , Unrelated DonorsABSTRACT
20.0?109/L was day 13(11~21).All the patients got engraftment successfully and attained CR.Acute Ⅰ~Ⅱ GVHD occurred in 5 patients,no acute Ⅲ~Ⅳ GVHD occurred and extensive chronic GVHD did in 2 patients.All the patients were alive and only one patient relapsed after 3~53 months follow-up.Conclusion TBI-based conditioning regimen appears to be safe and effective for non-T-depleted HLA mismatched hemotopoietic stem cell transplants,especially for high-risk and second transplant patients.