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T-cell deplete versus T-cell replete haploidentical hematopoietic stem cell transplantation for sickle cell disease: where are we?

Authors
  • Patel, Dilan A1
  • Akinsete, Adeseye M2
  • Connelly, James A3
  • Kassim, Adetola A1
  • 1 Department of Medicine, Division of Hematology/Oncology, Vanderbilt-Meharry Center for Excellence in Sickle Cell Disease, Vanderbilt University Medical Center , Nashville , TN , USA.
  • 2 College of Medicine, Division of Pediatric Hematology & Oncology, Lagos University Teaching Hospital , Lagos , Nigeria. , (Niger)
  • 3 Department of Pediatrics, Pediatric Hematopoietic Cell Transplant, Vanderbilt University Medical Center , Nashville , TN , USA.
Type
Published Article
Journal
Expert Review of Hematology
Publisher
Informa UK (Taylor & Francis)
Publication Date
Sep 01, 2019
Volume
12
Issue
9
Pages
733–752
Identifiers
DOI: 10.1080/17474086.2019.1642103
PMID: 31291790
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Introduction: Severe sickle cell disease is associated with progressive end-organ damage and early mortality in adults. While allogeneic hematopoietic cell transplant from a matched related donor is curative, the vast majority of patients do not have a compatible sibling. Accordingly, platforms using haploidentical donors have been developed, which provide near-universal availability. Areas covered: This review focuses on the two commonly used approaches for haploidentical hematopoietic transplants, namely T-cell deplete and T-cell replete, each of which is associated with unique benefits and drawbacks. The purpose of this paper is to facilitate individualized decision-making for patients and providers by reviewing the pros- and cons of these differing approaches. Expert opinion: Individuals with sickle cell disease eligible for a hematopoietic cell transplant can be considered based on recent results. Comparable outcomes are seen with T-cell deplete and T-cell replete approaches. The choice depends largely on institutional preference.

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