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Selective Allo-depletion: TcRαβ and CD19+ T-Cell Depletion

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Haploidentical Transplantation

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Abstract

Haploidentical hematopoietic cell transplantation is a curative alternative option for patients without an otherwise HLA-matched suitable donor. In order to prevent graft-versus-host disease, different in vitro and in vivo T-cell depletion strategies have been developed. A delayed immune reconstitution is common to all these strategies, and an impaired immune function after haploidentical transplantation with subsequent infections is a major cause of deaths in these patients. Attempts to improve immune reconstitution and to better exploit the graft-versus-malignancy effect after transplantation of T-cell-depleted grafts through the preservation of immune effector cells led to the development of the TcRαβ-/CD19-negative depletion strategy of mobilized peripheral blood grafts. A faster immune reconstitution has been observed in patients with negatively depleted grafts after haploidentical transplantation, although no prospective randomized trials have been reported to date. In this chapter, the recent clinical data obtained with TcRαβ-depleted haploidentical grafts in children and adult patients will be described, and the role of haploidentical transplantation of TcRαβ-depleted grafts as a platform for posttransplant immunotherapy will be discussed.

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Conflict of Interest

R.H. is a co-patent holder of TcRαβ depletion.

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Authors and Affiliations

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

    Franco Aversa

  2. Department of Hematology/Oncology, Children’s University Hospital, University of Tuebingen, Tuebingen, Germany

    Peter Lang & Rupert Handgretinger

  3. Department of General Pediatrics, Children’s University Hospital, University of Tuebingen, Tuebingen, Germany

    Rupert Handgretinger

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  1. Franco Aversa
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  2. Peter Lang
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  3. Rupert Handgretinger
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Correspondence to Rupert Handgretinger .

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Editors and Affiliations

  1. Department of Stem Cell Transplantation, MD Anderson Cancer Center, Houston, Texas, USA

    Stefan O. Ciurea

  2. Department of General Pediatrics and Hematology/Oncology, University Children’s Hospital, Tübingen, Baden-Württemberg, Germany

    Rupert Handgretinger

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Aversa, F., Lang, P., Handgretinger, R. (2018). Selective Allo-depletion: TcRαβ and CD19+ T-Cell Depletion. In: Ciurea, S., Handgretinger, R. (eds) Haploidentical Transplantation. Advances and Controversies in Hematopoietic Transplantation and Cell Therapy. Springer, Cham. https://doi.org/10.1007/978-3-319-54310-9_3

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  • DOI: https://doi.org/10.1007/978-3-319-54310-9_3

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