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The historical experience with haploidentical stem cell transplantation has been characterised by the immunological consequences of crossing a major histocompatibility barrier, namely graft\u2010<jats:italic>versus<\/jats:italic>\u2010host disease (GVHD), graft rejection and impaired immune reconstitution. <jats:italic>Ex vivo<\/jats:italic> T\u2010cell depletion of the graft may reduce the risk of GVHD, but at the expense of a higher risk of engraftment failure and relapse of the underlying malignancy. Myeloablative transplant strategies using vigorously T\u2010cell\u2010depleted \u2018megadose\u2019 stem cells appear to have improved the outcomes of selected patients with acute leukaemia. Non\u2010myeloablative stem cell transplantation strategies, in which mixed chimaerism as a platform for adoptive cellular immunotherapy is intentionally induced, show promise for limiting GVHD and lessening transplant\u2010related mortality. 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