About this Research Topic
Allogeneic stem cell transplantation (Allo-SCT) remains an important strategy to treat several hematological diseases. In the last years, many advances have been made in the field regarding donors and recipient selection, conditioning regimens, GVHD prophylaxis and treatment, and infection control. All of these changes concur to improve outcomes and to offer transplantation to a larger number of patients. Indeed, the age per se cannot be considered a limiting factor. Moreover, allo-SCT can be considered as a part of global disease treatments as the rebuilding of immunological backgrounds can create the basis for therapy after transplantation to minimize the risk of relapse.
In this Research Topic, we aim to address aspects of transplantation where great changes have been achieved. For many years, the age of recipients and the availability of donors have limited the affordability of this treatment, restricting it to young patients (less than 45 years) with HLA identical siblings or matched unrelated donors. These statements are now outdated and new issues have presented themselves. For example, hierarchy issues regarding the most suitable kind of donor are emerging. Even considering the HLA identical sibling (HLAid sib) as the “reference” donor, can all other alternative donors be considered equivalent in terms of efficacy or toxicity?
Furthermore, significant changes have been observed in infection control (i.e. CMV infection), GVHD prophylaxis (i.e. post-transplantation cyclophosphamide) and post-transplant treatment (i.e. FLT3 inhibitors). Patient data from many centers has also been collected in international registries and information from these registries are extremely important in the field of transplantation, where randomized and prospective studies are hard to perform and subsequent papers are of high interest. For this reason, we would appreciate overviews of data obtained in the last 10 years from the EBMT and CIBMTR. Lastly, we would like to address the usage of allo-SCT outside of academic centers and in emerging countries, in both cases with specificities and adjustments.
Therefore, in this Research Topic, we would like to address the aforementioned issues through the following themes:
• Donor choice;
• Recipient characteristics;
• Conditioning regimens in malignant and non-malignant diseases;
• GVHD prophylaxis;
• Post-transplant strategies;
• Results from registries and from non-academic centers or low-income countries;
Different aspects of each topic should be discussed based on literature evidence and personal opinions.
Keywords: Adoptive Immunotherapy, Conditioning Regimen, Donor, Hematological Diseases, Allogeneic Transplantation
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