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Everyone has a donor: contribution of the Chinese experience to global practice of haploidentical hematopoietic stem cell transplantation

Abstract

Human leukocyte antigen (HLA)-matched donors for hematopoietic stem cell transplantation (HSCT) have long been scarce in China. Haploidentical (haplo) donors are available for the vast majority of patients, but toxicity has limited this approach. Three new approaches for haplo-HSCT originated from Italy, China, and USA in 1990 and have been developed to world-renowned system up to now. The Chinese approach have been greatly improved by implementing new individualized conditioning regimens, donor selection based on non-HLA systems, risk-directed strategies for graft-versus-host disease and relapse, and infection management. Haplo-HSCT has exhibited similar efficacy to HLA-matched HSCT and has gradually become the predominant donor source and the first alternative donor choice for allo-HSCT in China. Registry-based analyses and multicenter studies adhering to international standards facilitated the transformation of the unique Chinese experience into an inspiration for the refinement of global practice. This review will focus on how the new era in which “everyone has a donor” will become a reality in China.

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Acknowledgements

We would like to thank the American Journal Experts (https://www.aje.com) for providing editorial assistance. This work was supported by the National Natural Science Foundation of China (Nos. 81400146, 81470342, and 81670168), the Foundation for Innovative Research Groups of the National Natural Science Foundation of China (No. 81621001), and the Key Program of the National Natural Science Foundation of China (Nos. 81530046 and 81230013).

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Lv, M., Chang, Y. & Huang, X. Everyone has a donor: contribution of the Chinese experience to global practice of haploidentical hematopoietic stem cell transplantation. Front. Med. 13, 45–56 (2019). https://doi.org/10.1007/s11684-017-0595-7

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Keywords

  • haploidentical hematopoietic stem cell transplantation
  • conditioning
  • graft-versus-host disease
  • relapse
  • infection
  • donor selection