Haploidentical hematopoietic stem cell transplantation without in vitro T-cell-depletion for the treatment of hematologic diseases.

Haploidentical hematopoietic stem cell transplantation (HSCT) has been accepted worldwide as an alternative treatment for patients with hematologic diseases who do not have a human leukocyte antigen (HLA) identical sibling donor or who require urgent transplantation. The results from our nine-year experience showed that granulocyte colony-stimulating factor (G-CSF) primed bone marrow (G-BM) combined with peripheral blood grafts (G-PB) from haploidentical donors, without in vitro T cell depletion (TCD), is a reliable source of stem cells for transplantation to cure acute leukemia and chronic myeloid leukemia. Recent findings confirmed that unmanipulated haploidentical HSCT is a promising protocol that can be successfully extended to treat intermediate and high-risk myelodysplastic syndrome and severe aplastic anemia. Recent observations suggest the association of improved immune recovery with better transplant outcomes after haploidentical HSCT. Chronic graft-vs.-host-disease severity strongly correlates with negative impacts on patients' health-related quality of life, suggesting that it should be successfully controlled.