Développement des greffes haplo-identiques chez l'adulte atteint d'une hémopathie maligne

The possibility to use a family donor sharing only one haplotype with recipient affected by hematological malignancy has been searched from many years because it allows having a donor in every case for every patient. At the beginning, this kind of transplantation was considered too toxic, but after the development of specific strategies of conditioning regimens and ex vivo T-cell depletion, its feasibility and efficacy has been proved, mainly for acute leukemia. However, these haploidentical programs with ex vivo T-cell depletion need of sophisticated and dedicated laboratories and are characterized by frequent infectious complications and relapse, because of delayed immune reconstitution. For these reasons, many groups have developed alternative program for haploidentical transplantation, without ex vivo T-cell depletion, obtaining encouraging results in haematological malignancies. In this review, we analyze data produced by different groups, underscoring their principal characteristics.