Bibliographic Details
| Title: |
Results of haploidentical transplant in patients with donor-specific antibodies: a survey on behalf of the Spanish Group of Hematopoietic Transplant and Cell Therapy |
| Authors: |
Rebeca Bailén, Raquel Alenda, Beatriz Herruzo-Delgado, Cynthia Acosta-Fleitas, Ana Vallés, Albert Esquirol, Marta Fonseca, Laura Solán, Irene Sánchez-Vadillo, Guiomar Bautista, Leyre Bento, Oriana López-Godino, Ariadna Pérez-Martínez, Anna Torrent, Joud Zanabili, María Calbacho, Miguel Ángel Moreno, María Jesús Pascual-Cascón, Luisa Guerra-Domínguez, Anabelle Chinea, Irene García-Cadenas, Lucía López-Corral, Francisco Boix-Giner, José Luis López Lorenzo, Karem Humala, Rafael Duarte, Antonia Sampol, Inmaculada Heras, José Luis Vicario, Antonio Balas, Gillen Oarbeascoa, Paula Fernández-Caldas, Javier Anguita, Mi Kwon |
| Source: |
Frontiers in Immunology, Vol 14 (2023) |
| Publisher Information: |
Frontiers Media S.A., 2023. |
| Publication Year: |
2023 |
| Collection: |
LCC:Immunologic diseases. Allergy |
| Subject Terms: |
donor-specific antibodies, graft failure, haplo-HSCT, desensitization strategies, DSA kinetics, Immunologic diseases. Allergy, RC581-607 |
| More Details: |
BackgroundDonor-specific antibodies (DSAs) are IgG allo-antibodies against mismatched donor HLA molecules and can cause graft failure (GF) in the setting of haploidentical hematopoietic stem cell transplantation (haplo-HSCT). Our aim was to report the experience of the Spanish Group of Hematopoietic Transplant (GETH-TC) in DSA-positive patients who had undergone haplo-HSCT.MethodsWe conducted a survey of patients who underwent haplo-HSCT in GETH-TC centers between 2012 and 2021. Data were collected on the DSA assay used, monitoring strategy, complement fixation, criteria for desensitization, desensitization strategies and transplant outcomes.ResultsFifteen centers from the GETH-TC responded to the survey. During the study period, 1,454 patients underwent haplo-HSCT. Seventy of the transplants were performed in 69 DSA-positive patients, all of whom lacked a suitable alternative donor; 61 (88%) patients were female (90% with prior pregnancies). All patients received post-transplant cyclophosphamide-based graft-versus-host disease prophylaxis. Regarding baseline DSA intensity, 46 (67%) patients presented mean fluorescence intensity (MFI) >5,000, including 21 (30%) with MFI >10,000 and three (4%) with MFI >20,000. Six patients did not receive desensitization treatment, four of them with MFI 20,000 as an independent risk factor for survival and an increase in titers after infusion as an independent risk factor for GF.ConclusionsHaplo-HSCT is feasible in DSA-positive patients, with high rates of engraftment after desensitization guided by DSA intensity. Baseline MFI >20,000 and increased intensity after infusion are risk factors for survival and GF. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
1664-3224 |
| Relation: |
https://www.frontiersin.org/articles/10.3389/fimmu.2023.1165759/full; https://doaj.org/toc/1664-3224 |
| DOI: |
10.3389/fimmu.2023.1165759 |
| Access URL: |
https://doaj.org/article/d812f3ccea2048e3ae13b72a5bfca97c |
| Accession Number: |
edsdoj.812f3ccea2048e3ae13b72a5bfca97c |
| Database: |
Directory of Open Access Journals |
