Haematopoietic stem-cell transplantation in China in the era of targeted therapies: current advances, challenges, and future directions.

Abstract

In the era of targeted therapies, haematopoietic stem-cell transplantation (HSCT), both allogeneic and autologous, remains a curative approach for patients with chemosensitive and immunesensitive malignant and non-malignant haematological disease in China. Since 2000, we have seen a substantial increase in the number of HSCTs, especially haploidentical HSCT, in patients with acute leukaemia and severe aplastic anaemia. Haploidentical donors have been the most common allograft donors in China since 2013. Key components of allogeneic HSCT include best donor selection for acute leukaemia, incorporation of target therapy, especially chimeric antigen receptor T cells, allografts for acute leukaemia outcome improvement, total therapy for relapsed or refractory acute leukaemia and haploidentical allografts as upfront therapy for severe aplastic anaemia. Despite many challenges in the HSCT setting in China, such as how to redefine the roadmap for HSCT, improve the health-related quality of life of long-term surviving transplant recipients, and promote national and international collaboration, allogeneic HSCT and autologous HSCT will continue to have an important role in treating diverse diseases between now and 2050. The development of HSCT in China will contribute to the worldwide development of HSCT.