HLA-identical siblings versus haploidentical donors: full match still beats half match

Abstract

The resurgence of haploidentical donor transplantation over the past decade is a major advance in the field of hematopoietic cell transplantation (HCT). Several platforms have been described, such as ex vivo T-cell depletion techniques with positive-CD34+ selection, ‘mega-dose’ of purified CD34+ cells, or selective depletion of T-cells, and T-cell replete approaches that include use of intensified immune suppression or post-transplant high-dose cyclophosphamide.1, 2, 3 It is safe to say that haploidentical transplantation has become a well-accepted alternative donor source, with several studies reporting survival comparable to umbilical cord blood and matched unrelated donors.4, 5, 6, 7, 8 Ongoing clinical trials such as the BMT CTN 1101 (double cord versus haplo) will further clarify where haploidentical donors factor into the donor selection process.