Citations

Haploidentical stem cell transplantation provides a plausible alternative for the patients when a fully matched donor is unavailable. Historically, the decision of considering haploidentical transplant has remained elusive; however, with the recent advances, the consideration of haploidentical grafts as a treatment option has become more apparent for both allografting for diseases and engraftment failure. We are reporting here an anecdotal case of a successful haploidentical engraftment in a patient with the prior graft failure of an HLA-matched related donor. Since the patient was severely alloimmunized, desensitization protocol was utilized before the haploidentical transplant, and the patient after 8 months of her second allogeneic transplantation is doing great with successful engraftment, no relapse, and no graft-versus-host disease (GVHD). Numerous reports pertinent to haploidentical graft have shown favorable outcomes in the graft placement, a decline in the rate of GVHD, and an improvement in the morbidity and mortality in affected individuals. Based on the current reports, haploidentical transplantation might be more feasible and has meaningful implications in the situations where matched donors are infrequent.

AbstractIntroductionThe field of allogeneic hematopoietic cell transplantation (allo‐HCT) began in the 1950s, and despite a seven decade history of remarkable clinical advances, graft‐versus‐host‐disease (GVHD) remains the greatest obstacle in its success due to considerable morbidity and mortality. Graft‐versus‐host disease is the second leading cause of transplantation‐related mortality (TRM) after relapse of primary disease. There are two main types of GVHD—acute and chronic—differing in the pathogenesis, time of onset, and clinical presentation.ObjectiveThis review provides a comprehensive overview of chronic GVHD pathophysiology and current management paradigms, as well as consideration of promising novel therapies.ConclusionChronic GVHD is a serious disease which may be active for years, or even decades, requiring potentially years of immunosuppressive therapies and placing patients at risk for a number of late complications. While the oral cavity has long been recognized to be a prominent target of GVHD, and in particular, chronic GVHD, it must be recognized and appreciated that it is a complex systemic disease with a wide spectrum of clinical manifestations.

Key Points Compared with parous female sibling donors, male URDs confer more aGVHD in all patients and more cGVHD in females. There was no difference in survival, relapse, or transplant mortality between recipients of parous female sibling or male URD grafts.