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This study is a first step towards the transfer of knowledge and practices between psychological support and performance in elite sport and a patient's "social recovery" in oncology. This proposal brings together people engaged in a variety of healthcare and relationship support roles, and aims to set up a support system beyond the hospital context. It questions the ability of elite sport management and its main actors, the "Great Coaches", to contribute to the support of patients in cancer remission through an onco-coaching approach. This innovative proposal is initiated by a life coaching pilot study designed for hematologic cancer patients in remission after a hematopoietic stem cell transplantation., (Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Haploidentical hematopoietic stem cell transplantation (HSCT) is being increasingly used due to improvement of the transplantation procedures allowing a reduction of graft-versus-host-disease (GVHD) and of transplant-related mortality (TRM). Such improvements have been particularly observed after administration of T-replete HSCT graft associated to an in vivo T cell depletion by the administration of high-doses of cyclophosphamide (HD-Cy) after transplantation. Here, we have analyzed the results of haplo-identical T replete HSC transplants, in particular, when performed with post-transplant HD-Cy in order to provide recommendations for the clinical practice. Criteria of choice for a haploidentical donor by priority order are absence of donor-specific antibodies (DSA) and to prioritize: CMV seronegative recipient/donor couples, ABO matching in case of deserythrocytation, male donor for a male recipient, the youngest donor. There is no clear argument in favor of the use of bone marrow versus peripheral blood stem cells (PBSC) after non myeloablative conditioning regimen, while after ablative conditioning PBSC seem to be associated with higher risks of GVHD without obvious impact on survival. Results of haploidentical HSCT, confirmed by several groups, are interesting in lymphomas (in particular Hodgkin disease) and for acute leukemia. Outcomes of patients rely on age, disease status at transplant and conditioning intensity. At equivalent disease risk, results of haploidentical HSCT seem comparable to those of HLA matched HSCT, raising the question of the classification of such transplants as alternatives. In all cases, we recommend to include patients in prospective clinical trials., (Copyright © 2016 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

The possibility to use a family donor sharing only one haplotype with recipient affected by hematological malignancy has been searched from many years because it allows having a donor in every case for every patient. At the beginning, this kind of transplantation was considered too toxic, but after the development of specific strategies of conditioning regimens and ex vivo T-cell depletion, its feasibility and efficacy has been proved, mainly for acute leukemia. However, these haploidentical programs with ex vivo T-cell depletion need of sophisticated and dedicated laboratories and are characterized by frequent infectious complications and relapse, because of delayed immune reconstitution. For these reasons, many groups have developed alternative program for haploidentical transplantation, without ex vivo T-cell depletion, obtaining encouraging results in haematological malignancies. In this review, we analyze data produced by different groups, underscoring their principal characteristics.

Most of patients with hematological malignancies are elderly (more than 60  years). Allogeneic stem cell transplantation is an important and effective treatment for most of these diseases. However, the toxicity and the supposed frailty of elderly patients, have limited the applicability of allogeneic transplantation for these patients. Elderly patients are at high risk to develop life-threatening complications, if allogeneic transplantation is performed with myeloablative conditioning regimens and using bone marrow stem source. Since more than 10 years, reduced intensity conditioning regimen have been developed, allowing to overcome the age as contra-indication for allogeneic transplantation. On the other hand, it is the presence of comorbidities which identify frail patients. For these subjects, allogeneic transplantation should be not indicated. Furthermore, advances in the supportive care and the development of new molecules could allow to reduce the toxicity of myeloablative conditioning regimens and thus to offer more intensive regimens before transplantation also in elderly population.

Prognosis of acute myeloblastic leukemias (AML) remains with relapse, at a time when progress in chemotherapy regimens have increased the rate of complete remission, and improved biological tools have helped in defining diagnostic and prognostic criteria for this heterogeneous group of diseases. Allogeneic stem cell transplantation offers an example of a situation in which various immune effectors can contribute to the eradication of residual leukemic cells. However, use of allogeneic transplantation is restricted to a minority of patients. Thus, the development of immunotherapy strategies that could be used for all patients, appears highly desirable. Progress in fundamental immunology, and a better understanding of the role of the immune system in the physiopathology of leukemias now open new avenues to design innovative therapies. We here review recently published observations in this field, and propose new vaccine programs that use autologous AML blasts differentiated into dendritic cells., (John Libbey Eurotext 2003)