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The European Society for Blood and Marrow Transplantation (EBMT) consensus recommendations for donor selection in haploidentical hematopoietic cell transplantation

Bone Marrow Transplantation volume 55, pages 12–24 (2020)Cite this article

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Abstract

The number of HLA-haploidentical hematopoietic cell transplants continues to increase worldwide due to recent improvements in outcomes, allowing more patients with hematological malignancies and non-malignant disorders to benefit from this procedure and have a chance to cure their disease. Despite these encouraging results, questions remain as multiple donors are usually available for transplantation, and choosing the best HLA-haploidentical donor for transplantation remains a challenge. Several approaches to haploidentical transplantation have been developed over time and, based on the graft received, can be grouped as follows: T-cell depleted haploidentical transplants, either complete or partial, or with T-cell replete grafts, performed with post-transplant cyclophosphamide-based graft-versus-host disease (GVHD) prophylaxis, or G-CSF-primed bone marrow graft and enhanced GVHD prophylaxis. Carefully selecting the donor can help optimize transplant outcomes for recipients of haploidentical donor transplants. Variables usually considered in the donor selection include presence of donor-specific antibodies in the recipient, donor age, donor/recipient gender and ABO combinations, and immunogenic variables, such as natural killer cell alloreactivity or KIR haplotype. Here we provide a comprehensive review of available evidence for selecting haploidentical donors for transplantation, and summarize the recommendations from the European Society for Blood and Marrow Transplantation (EBMT) on donor selection for different transplant platforms.

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Authors and Affiliations

  1. The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Stefan O. Ciurea

  2. Department of Hematology and HCT, City of Hope National Medical Center, Duarte, CA, USA

    Monzr M. Al Malki

  3. Department of Medicine, Thammasat University, Pathumthani, Thailand

    Piyanuch Kongtim

  4. Division of Hematologic Malignancies, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA

    Ephraim J. Fuchs & Leo Luznik

  5. Institute of Hematology, Peking University People’s Hospital, Beijing, China

    Xiao-Jun Huang

  6. Hematology and BMT Unit, San Raffaele Scientific Institute, Milan, Italy

    Fabio Ciceri

  7. Department of Pediatric Hematology and Oncology, IRCCS Ospedale Pediatrico Bambino Gesu, University La Sapienza, Rome, Italy

    Franco Locatelli

  8. Hematology and BMT Unit, University of Parma, Parma, Italy

    Franco Aversa

  9. Hematology Department, Humanitas Clinical and Research Center, Milan, Italy

    Luca Castagna

  10. Instituto di Ematologia, Fondazione Policlinico Universitario Gemelli, IRCCS, Universita’ Cattolica del Sacro Cuore, Roma, Italy

    Andrea Bacigalupo

  11. University of Perugia, Perugia, Italy

    Massimo Martelli

  12. Departement D’Hematologie, Programme de Transplantation et de Therapie Cellulaire, Aix Marseille Univ, Inserm, CNRS, CRCM, Marseille, France

    Didier Blaise

  13. Departement de Psychologie Clinique, Institut Paoli Calmettes, Marseille, France

    Patrick Ben Soussan & Yolande Arnault

  14. Department of Hematology and Oncology, Children’s University Hospital, Tubingen, Germany

    Rupert Handgretinger

  15. Blood and Marrow Transplantation Program, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, QC, Canada

    Denis-Claude Roy

  16. Massachusetts General Hospital Cancer Center, Boston, MA, USA

    Paul V. O’Donnell

  17. BMT Program at Northside Hospital, Atlanta, GA, USA

    Asad Bashey & Scott Solomon

  18. Dana Farber Cancer Institute, Boston, MA, USA

    Rizwan Romee

  19. Facultad de Medicina Universidad Complutense, HGU Gregorio Maranon, Madrid, Spain

    Jorge Gayoso

  20. Case Western Reserve University, Cleveland, OH, USA

    Hillard M. Lazarus

  21. University of Virginia Health System, Charlottesville, VA, USA

    Karen Ballen

  22. Vanderbilt University Medical Center, Nashville, TN, USA

    Bipin N. Savani

  23. Hopital Saint-Antoine, Paris, France

    Mohamad Mohty

  24. Acute Leukemia Working Party of the EBMT, Hopital Saint-Antoine, Paris, France

    Mohamad Mohty & Arnon Nagler

  25. Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel

    Arnon Nagler

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  1. Stefan O. Ciurea
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Correspondence to Stefan O. Ciurea.

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Ciurea, S.O., Al Malki, M.M., Kongtim, P. et al. The European Society for Blood and Marrow Transplantation (EBMT) consensus recommendations for donor selection in haploidentical hematopoietic cell transplantation. Bone Marrow Transplant 55, 12–24 (2020). https://doi.org/10.1038/s41409-019-0499-z

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  • DOI: https://doi.org/10.1038/s41409-019-0499-z

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