2012 Volume 1 Issue 3 Pages 66-75
An HLA-matched singling is the ideal donor for allogeneic hematopoietic stem cell transplantation (HSCT), but such a donor is available for less than 30% of patients who require allogeneic HSCT. Therefore, HLA-matched unrelated HSCT, HLAmismatched related HSCT, and unrelated cord blood transplantation have been investigated. One-antigen mismatched related HSCT can be performed without T-cell depletion, but the outcome has been somewhat inferior to HSCT from an HLA-matched sibling or HSCT from an HLA-allele-matched unrelated donor. The use of in vivo T-cell depletion may improve its outcome. Two- or three-antigen mismatched related HSCT without ex vivo T-cell depletion has been investigated in Japan using a variety of strategies including in vivo T-cell depletion using anti-thymocyte globulin or alemtuzumab, and its safety has become close to that of HLA-matched HSCT. However, the appropriate choice of these strategies as well as the difference in HSCT outcome with cord blood transplantation has not been clarified.
