Onkológia 1/2025
Haploidentical hematopoietic cell transplantation
Allogeneic hematopoietic cell transplantation is an established treatment for a wide range of hematological diseases and other serious disorders of hematopoietic system. However, limited access to suitable donors, especially for patients without a HLA (human leukocyte antigen) identical matched donor, has led to the development of haploidentical transplantation. Haploidentical transplantation differs from classical allogeneic transplantation in the degree of genetic histocompatibility between the donor and the recipient. A haploidentical donor is 50% identical to the recipient in HLA markers, which poses a challenge for immune tolerance, as differences in histocompatibility antigens can lead to a strong immune response. For the successful implementation of haploidentical transplantation, it is essential to overcome immune mechanisms such as graft rejection and graft-versus-host disease (GvHD) while maintaining antitumor effects. This type of transplantation has become a key therapeutic approach in the treatment of many patients with hematological malignancies, allowing for wider access to donors, especially in populations where it is less likely to find a completely HLA-matched donor. This article focuses on advances in haploidentical transplantation, mechanisms of immune tolerance, technologies to reduce the risk of graft rejection and GvHD. I also report clinical results and perspectives for future research in this area.
Keywords: haploidentical transplantation, HLA-matched donor, graft rejection, graft-versus-host disease
