For years, most leukemia patients had no fully HLA-matched donor and simply ran out of time. The Beijing Protocol, created by Prof. Huang Xiaojun’s team at Peking University People’s Hospital, turned parents, children and siblings into eligible donors—and became the world’s most widely used haploidentical transplant system.
Credit: Peking University People’s Hospital official website (2023 news photo of the Tongzhou transplant ward)
How it works: retrain T cells instead of removing them
Hematopoietic stem cell transplantation (HSCT) is a key curative-intent treatment for leukemia and other blood cancers. High-dose chemotherapy or radiotherapy—the conditioning regimen—first clears the patient’s marrow. Donor stem cells are then infused to rebuild blood and immunity, while donor immune cells also mount a graft-versus-leukemia (GVL) effect against any remaining tumor.
For decades, transplant required a donor matched at all ten HLA loci. Even among siblings, a full match has only about a 25% chance, and at one point just 41% of Chinese patients could find a matched unrelated donor. A parent and child are inevitably half-matched—haploidentical—but early attempts were punishing: roughly 20% of grafts failed and 70% developed graft-versus-host disease (GVHD). In the 1980s, fewer than one in five US patients survived, and haploidentical transplant was considered off-limits.
Prof. Huang’s team rejected the mainstream approach of removing T cells outside the body, which also discards their anti-tumor, engraftment and immune-recovery benefits. Instead, they retrain T cells : G-CSF (granulocyte colony-stimulating factor) “educates” donor T cells, shifting them toward Th2 and regulatory phenotypes so they attack less. The graft combines G-CSF-mobilized bone marrow with peripheral blood stem cells, keeping T and NK cells, while antithymocyte globulin (ATG) given to the patient forms a G-CSF plus ATG tolerance-inducing regimen—GVHD goes down while the GVL effect stays.
Together with individualized conditioning, donor selection (younger, male donors preferred) and structured post-transplant immune management, these steps form a reproducible system. In 2000 , the team performed the world’s first haploidentical transplant without ex vivo T-cell depletion—a father donating to his son. That patient is still alive today.
Figure 1. How the Beijing Protocol works: G-CSF modulates donor T cells, marrow plus peripheral blood stem cells are grafted, and ATG regulates immunity in vivo—lower GVHD with the GVL effect preserved.
Treatment process: four steps
1 Donor mobilization and collection
A haploidentical parent, child or sibling receives G-CSF, then bone marrow and peripheral blood stem cells are collected.
2 Patient conditioning
A myeloablative or reduced-intensity regimen—busulfan, cyclophosphamide, fludarabine and ATG in various combinations—is tailored to disease and age.
3 Stem cell infusion
The G-CSF-mobilized marrow plus peripheral blood graft is infused to rebuild blood and immunity.
4 Post-transplant management
GVHD prevention, infection care, chimerism monitoring and structured immune-reconstruction and relapse management.
Clinical results: from 20% to about 70%
According to a September 18, 2026 Xinhua interview with Prof. Zhang Xiaohui of Peking University Institute of Hematology and to hospital data, the Beijing Protocol achieves about 99% engraftment , with moderate-to-severe GVHD held near 10% .
Three-year survival after haploidentical transplant for leukemia has risen from about 20% in the early era to roughly 70%. Hospital figures show around 70% three-year disease-free survival and 74%–79% three-year overall survival in acute leukemia. The team was the first worldwide to show that haploidentical transplant beats chemotherapy alone and matches the results of fully matched transplant.
At scale, China performed over 17,000 haploidentical transplants in 2025 and more than 100,000 over the past two decades . Chinese registry data show annual haploidentical cases growing from 337 in 2008 to 9,908 in 2023—94% using the Beijing Protocol model—while transplant centers expanded from 27 to 212. Peking University People’s Hospital is the world’s largest haploidentical transplant center; its Tongzhou campus is Asia’s largest single bone-marrow transplant facility.
In severe aplastic anemia, haploidentical transplant reaches 86%–89% three-year overall survival and about 85% at nine years, matching matched-donor results; the New England Journal of Medicine called it encouraging Chinese experience. The protocol now covers more than 20 categories and 70-plus blood diseases.
Three global platforms and international recognition
Three haploidentical platforms exist worldwide. Italy’s Perugia approach depletes T cells outside the body: GVHD is low, but rejection runs 10%–15%, immune recovery is slow, and early non-relapse mortality reached about 40%–50%. The US Baltimore approach uses high-dose post-transplant cyclophosphamide (PTCy) to kill activated T cells—cheaper and now widespread, though with relatively higher infection and relapse rates. China’s Beijing Protocol regulates immunity inside the body, and a Chinese registry matched analysis found faster blood recovery and longer survival than PTCy.
In 2016 , the Worldwide Network for Blood and Marrow Transplantation (WBMT, linked to the WHO) formally named the system the Beijing Protocol—the first China-created, world-class transplant regimen named after Beijing. It has been cited in more than 40 international guidelines and consensus documents and is routine practice in France, Italy, Israel, Japan and South Korea. In 2024 Prof. Huang received the CIBMTR Distinguished Service Award; the citation called the Beijing Protocol the most widely used and most effective haploidentical transplant system in the world.
Safety and suitability
Transplant remains a high-risk procedure: conditioning-related toxicity, opportunistic infections before immune recovery, GVHD, relapse and poor graft function can all occur. It should be performed only in a center with laminar-airflow wards and comprehensive support services.
Older or less fit patients may receive reduced-intensity conditioning with individualized assessment; Peking University People’s Hospital set an Asian record with an allogeneic transplant recipient aged 77.
Length of treatment Patients spend several weeks in a laminar-flow ward, with long overall treatment and follow-up and substantial costs; plan ahead.
New fields still experimental Use in autoimmune disease and solid tumors remains under study and is not a standard indication.
What it means for overseas patients: everyone has a donor
The deepest value of the Beijing Protocol is that “everyone has a donor” : with a parent, child or sibling, a haploidentical donor is virtually guaranteed—the chance of a relative being eligible rises from under 25% to nearly 100%.
International patients no longer need to wait for the slim odds of a fully matched donor or an unrelated registry match. They can come to an experienced Chinese haploidentical center together with their family donor, cutting waiting time sharply. The donor usually needs only a short stay for G-CSF mobilization and collection; the patient’s indication and conditioning plan must be decided by transplant specialists after evaluation.
Beijing Protocol vs other major haploidentical transplant platforms (source: Chinese transplant registry, NCBI reviews)
Conditions It Can Treat
• Acute myeloid leukemia (AML)
• Acute lymphoblastic leukemia (ALL)
• Chronic myeloid leukemia (CML)
• Myelodysplastic syndromes (MDS)
• Lymphoma
• Multiple myeloma
• Aplastic anemia
• Thalassemia
• Paroxysmal nocturnal hemoglobinuria (PNH)
• Primary immunodeficiency / metabolic disorders
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