Haploidentical Family Donor Transplantation: At the Crossroads of a Changing Paradigm

The obvious advantage of haploidentical hematopoietic stem cell transplantation (HSCT) is that almost every patient who does not have HLA-identical donor or who urgently needs transplantation has at least one family member with whom to share one haplotype and who is promptly available as a donor. Over the past decade, haploidentical HSCT has spread to centers worldwide and several hundred patients have been treated even though significant variations on two main approaches have emerged over the past decade. Some centers have preferred an approach based on T cell depletion of G-CSF-mobilised peripheral blood progenitor cells (PBPCs); others have focused on manipulating the conditioning regimens and posttransplant immune suppression after the infusion of unmanipulated grafts