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Title: | Adverse effect of donor-specific anti-human leukocyte antigen (HLA) antibodies directed at HLA-DP/-DQ on engraftment in cord blood transplantation |
Authors: | Jo, Tomoyasu Arai, Yasuyuki https://orcid.org/0000-0002-9662-5093 (unconfirmed) Hatanaka, Kazuo Ishii, Hiroyuki Ono, Akiko Matsuyama, Nobuki Mori, Jumpei Koh, Yangsook Azuma, Fumihiro Kimura, Takafumi |
Author's alias: | 城, 友泰 新井, 康之 |
Keywords: | Cord-blood transplantation Donor-specific anti-HLA antibodies Engraftment HLA-DP HLA-DQ |
Issue Date: | Apr-2023 |
Publisher: | Elsevier BV |
Journal title: | Cytotherapy |
Volume: | 25 |
Issue: | 4 |
Start page: | 407 |
End page: | 414 |
Abstract: | [Background aims] While donor-specific anti-human leukocyte antigen (HLA) antibodies (DSAs) in the recipient before transplantation are associated with graft failure in cord-blood transplantation (CBT), effects of DSAs other than against HLA-A, -B or -DRB1 on transplantation outcomes remained poorly understood. [Methods] We retrospectively analyzed 567 single-unit CBT recipients to evaluate impact of DSAs against HLA-DP and -DQ on CBT outcomes. [Results] Among 143 recipients (25.2%) who had anti-HLA antibodies, nine harbored DSAs against HLA-DP or -DQ. DSAs against HLA-DP or -DQ were associated with a significantly lower neutrophil engraftment rate (55.6% versus 91.8%, P = 0.032) and with a marginally lower platelet engraftment rate (46.7% versus 75.3%, P = 0.128) at day 100 after transplantation, compared with patients without anti-HLA antibodies. Time to neutrophil and platelet engraftment in patients with DSAs for HLA-DP or -DQ was significantly longer than that in patients without anti-HLA antibodies (median, 25 versus 21 days, P = 0.002 in neutrophil; median 61 versus 46 days, P = 0.014 in platelet). Cumulative incidence of bacterial infection at day 100 was significantly greater (88.9% versus 57.1%, P = 0.024), and re-transplant-free survival was marginally lower (55.6% versus 76.8%, P = 0.132) in patients with DSAs against HLA-DP or -DQ, compared with those without anti-HLA antibodies. These findings suggest that DSAs against HLA-DP or -DQ lead to unfavorable engraftment, which may increase risk of bacterial infection, and reduce survival soon after CBT. [Conclusions] Our results suggest the importance of evaluating DSAs against HLA-DP and -DQ in recipients before selecting CB units. |
Rights: | © 2022 International Society for Cell & Gene Therapy. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license. |
URI: | http://hdl.handle.net/2433/282849 |
DOI(Published Version): | 10.1016/j.jcyt.2022.10.005 |
PubMed ID: | 36335019 |
Appears in Collections: | Journal Articles |
This item is licensed under a Creative Commons License