The decision to proceed to an allogeneic hematopoietic stem cell transplant (HSCT) must take into account the risk of the underlying disease balanced against many factors, including the morbidity and mortality associated with the procedure, patient preferences, and therapeutic alternatives. The broadening indications for HSCT, the trend to transplant older patients, the choice of multiple donors for transplant (sibling, unrelated, cord, haploidentical), and our increasing understanding of variables that contribute to the pathogenesis of graft-versus-host disease (GVHD) further underscore the need for careful assessment of the risk/benefit ratio before transplantation is undertaken.
In this educational session, Dr. Andrew Artz will discuss standard and novel prognostic tools that may aid in the selection of older HCT recipients and inform strategies to reduce transplant morbidity and mortality.
Dr. Katy Rezvani will discuss data on the KIR gene family as an independent second immunogenetic system, with significant influence on the outcome of allogeneic HSCT. She will argue that the time has arrived to consider the inclusion of KIR genotyping in the selection of donors predicted to be most effective at relapse protection.
Dr. Robert Jenq will discuss recent advances in the relationship between the microbiome and important outcomes after allogeneic transplant, including GVHD and relapse. He will also summarize clinical strategies that are being developed to offset the impact of microbiota injury.