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Advances in Hematology
Volume 2016 (2016), Article ID 4025073, 10 pages
http://dx.doi.org/10.1155/2016/4025073
Review Article

Donor Specific Anti-HLA Antibody and Risk of Graft Failure in Haploidentical Stem Cell Transplantation

1Department of Stem Cell Transplant and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
2Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathumthani 12120, Thailand
3Department of Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA

Received 7 November 2015; Accepted 22 December 2015

Academic Editor: Suparno Chakrabarti

Copyright © 2016 Piyanuch Kongtim et al. 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.

Abstract

Outcomes of allogeneic hematopoietic stem cell transplantation (AHSCT) using HLA-half matched related donors (haploidentical) have recently improved due to better control of alloreactive reactions in both graft-versus-host and host-versus-graft directions. The recognition of the role of humoral rejection in the development of primary graft failure in this setting has broadened our understanding about causes of engraftment failure in these patients, helped us better select donors for patients in need of AHSCT, and developed rational therapeutic measures for HLA sensitized patients to prevent this unfortunate event, which is usually associated with a very high mortality rate. With these recent advances the rate of graft failure in haploidentical transplantation has decreased to less than 5%.