HLA MATCHING IN HEMATOPOIETIC STEM CELL TRANSPLANTATION: WHERE DO WE STAND?
Despite the undeniable progress in the development of new effective drugs against malignant and non-malignant hematological diseases, allogeneic hematopoietic stem cell transplantation (HSCT) remains the only therapeutic option with long lasting curative potential. Continuous research for the last fifty years has repeatedly shown that HLA compatibility between recipient and donor constitutes the most decisive factor for successful engraftment and higher rates of overall survival. Unfortunately, a fully HLA matched donor is in many cases precluded, therefore the identification of better tolerated HLA mismatches has always been and still remains an important research objective. In this review we recapitulate current knowledge on how HLA- (i.e. locus, resolution level, directionality, number etc.) as well as non-HLA factors (i.e. disease stage, recipient age, graft source etc.) may impact the overall effect of HLA incompatibility on HSCT outcome, with the aim to offer an overview on potentially “permissive” HLA mismatches.
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