Haploidentical Transplantation in Children with Acute Leukemia: The Unresolved Issues

Allogeneic hematopoietic stem cell transplantation (HSCT) remains a curative option for children with high risk and advanced acute leukemia. Yet availability of matched family donor limits its use and although matched unrelated donor or mismatched umbilical cord blood (UCB) are viable options, they...

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Main Authors:	Jaiswal, Sarita Rani, Chakrabarti, Suparno
Format:	Online
Language:	English
Published:	Hindawi Publishing Corporation 2016
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4823496/

id	pubmed-4823496
recordtype	oai_dc
spelling	pubmed-48234962016-04-24 Haploidentical Transplantation in Children with Acute Leukemia: The Unresolved Issues Jaiswal, Sarita Rani Chakrabarti, Suparno Review Article Allogeneic hematopoietic stem cell transplantation (HSCT) remains a curative option for children with high risk and advanced acute leukemia. Yet availability of matched family donor limits its use and although matched unrelated donor or mismatched umbilical cord blood (UCB) are viable options, they fail to meet the global need. Haploidentical family donor is almost universally available and is emerging as the alternate donor of choice in adult patients. However, the same is not true in the case of children. The studies of haploidentical HSCT in children are largely limited to T cell depleted grafts with not so encouraging results in advanced leukemia. At the same time, emerging data from UCBT are challenging the existing paradigm of less stringent HLA match requirements as perceived in the past. The use of posttransplantation cyclophosphamide (PTCY) has yielded encouraging results in adults, but data in children is sorely lacking. Our experience of using PTCY based haploidentical HSCT in children shows inadequacy of this approach in younger children compared to excellent outcome in older children. In this context, we discuss the current status of haploidentical HSCT in children with acute leukemia in a global perspective and dwell on its future prospects. Hindawi Publishing Corporation 2016 2016-03-24 /pmc/articles/PMC4823496/ /pubmed/27110243 http://dx.doi.org/10.1155/2016/3467672 Text en Copyright © 2016 S. R. Jaiswal and S. Chakrabarti. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Jaiswal, Sarita Rani Chakrabarti, Suparno
spellingShingle	Jaiswal, Sarita Rani Chakrabarti, Suparno Haploidentical Transplantation in Children with Acute Leukemia: The Unresolved Issues
author_facet	Jaiswal, Sarita Rani Chakrabarti, Suparno
author_sort	Jaiswal, Sarita Rani
title	Haploidentical Transplantation in Children with Acute Leukemia: The Unresolved Issues
title_short	Haploidentical Transplantation in Children with Acute Leukemia: The Unresolved Issues
title_full	Haploidentical Transplantation in Children with Acute Leukemia: The Unresolved Issues
title_fullStr	Haploidentical Transplantation in Children with Acute Leukemia: The Unresolved Issues
title_full_unstemmed	Haploidentical Transplantation in Children with Acute Leukemia: The Unresolved Issues
title_sort	haploidentical transplantation in children with acute leukemia: the unresolved issues
description	Allogeneic hematopoietic stem cell transplantation (HSCT) remains a curative option for children with high risk and advanced acute leukemia. Yet availability of matched family donor limits its use and although matched unrelated donor or mismatched umbilical cord blood (UCB) are viable options, they fail to meet the global need. Haploidentical family donor is almost universally available and is emerging as the alternate donor of choice in adult patients. However, the same is not true in the case of children. The studies of haploidentical HSCT in children are largely limited to T cell depleted grafts with not so encouraging results in advanced leukemia. At the same time, emerging data from UCBT are challenging the existing paradigm of less stringent HLA match requirements as perceived in the past. The use of posttransplantation cyclophosphamide (PTCY) has yielded encouraging results in adults, but data in children is sorely lacking. Our experience of using PTCY based haploidentical HSCT in children shows inadequacy of this approach in younger children compared to excellent outcome in older children. In this context, we discuss the current status of haploidentical HSCT in children with acute leukemia in a global perspective and dwell on its future prospects.
publisher	Hindawi Publishing Corporation
publishDate	2016
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4823496/
_version_	1613563324125937664

Haploidentical Transplantation in Children with Acute Leukemia: The Unresolved Issues

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