HLA-haploidentical hematopoietic stem cell transplantation is now one of the most commonly employed alternative donor techniques, with most centers applying T-cell-replete strategies such as that developed by the Baltimore group using high-dose posttransplant cyclophosphamide. HLA-haploidentical hematopoietic stem cell transplantation using posttransplant cyclophosphamide is associated with low rates of severe graft-versus-host disease and nonrelapse mortality and does not require graft manipulation or storage, which results in a low graft acquisition cost. Its remarkable safety when used with reduced-intensity conditioning has been demonstrated in patients up to 75 years old with outcomes similar to those of patients in their 50s. Several large, registry-based retrospective studies have confirmed the efficacy of HLA-haploidentical hematopoietic stem cell transplantation with posttransplant cyclophosphamide, achieving results comparable to those of HLA-matched hematopoietic stem cell transplantation. In this article, we describe our approach to this rapidly available and clinically simple platform and address some of the key clinical questions associated with its use.

中文翻译：

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我们如何使用移植后环磷酰胺进行半相合干细胞移植

HLA 半相合造血干细胞移植现在是最常用的替代供体技术之一，大多数中心采用 T 细胞补充策略，例如巴尔的摩小组使用高剂量移植后环磷酰胺开发的策略。使用移植后环磷酰胺进行 HLA 半相合造血干细胞移植与严重的移植物抗宿主病和非复发死亡率低相关，并且不需要移植物操作或储存，从而导致移植物获取成本低。在 75 岁以下的患者中使用低强度调节时，它具有显着的安全性，其结果与 50 多岁的患者相似。几个大，基于注册的回顾性研究证实了 HLA 半相合造血干细胞移植与移植后环磷酰胺的疗效，其结果可与 HLA 匹配的造血干细胞移植相媲美。在本文中，我们描述了我们对这个快速可用且临床上简单的平台的方法，并解决了与其使用相关的一些关键临床问题。