Despite the advent of targeted therapies and novel agents, allogeneic hematopoietic stem cell transplantation remains the only\ncurative modality in the management of hematologic disorders. The necessity to find an HLA-matched related donor is a major\nobstacle that compromises the widespread application and development of this field. Matched unrelated donors and umbilical\ncord blood have emerged as alternative sources of donor stem cells; however, the cost of maintaining donor registries and cord\nblood banks is very high and even impractical in developing countries. Almost every patient has an HLA haploidentical relative\nin the family, meaning that haploidentical donors are potential sources of stem cells, especially in situations where cord blood or\nmatched unrelated donors are not easily available. Due to the high rates of graft failure and graft-versus-host disease, haploidentical\ntransplant was not considered a feasible option up until the late 20th century, when strategies such as ââ?¬Å?megadose stem cell infusionsââ?¬Â\nand posttransplantation immunosuppression with cyclophosphamide showed the ability to overcome the HLA disparity barrier\nand significantly improve the rates of engraftment and reduce the incidence and severity of graft-versus-host disease. Newer\ntechnologies of graft manipulation have also yielded the same effects in addition to preserving the anti leukemic cells in the donor\ngraft.
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