2021 Volume 10 Issue 1 Pages 48-57
HLA-haploidentical transplantation with posttransplant high-dose cyclophosphamide (PTCy-haplo) is becoming a platform for HLA-haploidentical transplantation. However, a series of recent meta-analytical reports have shown that although the risk of chronic GVHD in the PTCy-haplo is significantly lower than that in the HLA-matched transplantation, more risk of relapse was found in the PTCy-haplo than that in the HLA-matched unrelated transplantation. To reduce the incidence of relapse, it is important to analyze the underlying mechanisms of the (graft-versus-leukemia, GVL) effects of PTCy-haplo. Some reports have suggested that alloreactivity of NK cells plays a crucial role in the GVL effects of PTCy-haplo. However, NK cell recovery affected by PTCy has also been reported. In order to further improve outcomes in the PTCy-haplo, an evaluation of donor selection methods, amounts of cells in infused graft, optimal doses and timings of PTCy administration, and administration methods of immunosuppressive drug is required.
