Optimal donor selection for transplant to reduce GVHD risk and augment graft-versus-malignancy efficacy. Curr Opin Immunol 2026 Jun;100:102783
Date
05/01/2026Pubmed ID
42060959Pubmed Central ID
PMC13210405DOI
10.1016/j.coi.2026.102783Scopus ID
2-s2.0-105037085733 (requires institutional sign-in at Scopus site)Abstract
Allogeneic hematopoietic cell transplantation (alloHCT) is curative for many patients with high-risk, hematologic malignancies. AlloHCT depends on a graft versus malignancy (GVM) phenomenon, whereby donor-derived immune cells recognize and eradicate malignant host cells. Successful GVM correlates with the risk of alloreactivity against healthy tissues (graft-vs-host disease [GVHD]). HLA genes are central to immunologic recognition of self and mediate both GVM and GVHD. Historically, HLA-mismatched alloHCT was limited by the high incidence of severe GVHD. This led to a strong preference for HLA-matched donors, limiting access to HCT in patients without an HLA-matched donor. More recent advances in the prevention of GVHD, such as post-transplant cyclophosphamide, resulted in improved outcomes after HLA-mismatched donor HCT. New possibilities now exist to select donors for strategies designed to exploit GVM without significant GVHD. Here, we discuss the practical applications of donor selection to improve the overall efficacy of alloHCT.
Author List
Shaffer BC, Shaw BEAuthor
Bronwen E. Shaw PhD, MD Center Director, Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AnimalsDonor Selection
Graft vs Host Disease
Graft vs Tumor Effect
HLA Antigens
Hematologic Neoplasms
Hematopoietic Stem Cell Transplantation
Humans
Transplantation, Homologous
Treatment Outcome
