Alternative Donor Transplantation—“Mixing and Matching”: the Role of Combined Cord Blood and Haplo-Identical Donor Transplantation (Haplo-Cord SCT) as a Treatment Strategy for Patients Lacking Standard Donors?
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In the past decade, haplo-cord stem cell transplantation (SCT) using myeloablative or reduced intensive conditioning regimens has been shown to result in reliable and fast engraftment of neutrophils and platelets comparable to HLA-matched donors and much faster than after cord stem cell transplant. Haplo-cord SCT also has a low incidence of early non-relapse mortality, low incidences of acute and chronic graft-vs-host disease (GVHD), and excellent graft-vs-leukemia (GVL) effects. Favorable long-term outcomes for high-risk patients with hematologic malignancies have been reported, including older patients. Haplo-cord SCT will likely overcome the limitations of cell dose during cord stem cell selection and might significantly expand the use of cord stem cell transplant in the adult population. The comparable survival outcomes of matched related donor (MRD), matched unrelated donor (MUD), and haplo-cord stem cell transplant strongly argue that haplo-cord SCT should be considered as effective alternative stem cell transplant for high-risk patients lacking standard donors. Further improvement in supportive care and incorporation of a better understanding of the human fetal immune development into the haplo-cord SCT are required to further improve this strategy.
KeywordsHaplo-cord SCT Umbilical cord blood transplant Third-party donor cells Reduced intensity conditioning T cell depletion
Compliance with Ethics Guidelines
Conflict of Interest
Dr. Hongtao Liu is supported by grant from Cancer Research Foundation and K12 Paul Calabresi award.
Dr. Koen van Besien has research support from Miltenyi Biotec.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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