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Revista de investigación clínica

On-line version ISSN 2564-8896Print version ISSN 0034-8376

Abstract

JAIME-PEREZ, José C. et al. Anti-Hla Donor-Specific Antibodies Are Associated to Infection and Not to the Engraftment Rate in Outpatient Haploidentical Hematopoietic Cell Transplantation. Rev. invest. clín. [online]. 2023, vol.75, n.5, pp.249-258.  Epub Mar 12, 2024. ISSN 2564-8896.  https://doi.org/10.24875/ric.23000121.

Background:

Recipients of a related haploidentical stem cell transplant (haplo-SCT) can have preformed antibodies to HLA donor’s antigens.

Objective:

The aim of the study was to evaluate the engraftment rate and major clinical associations of anti-HLA donor-specific antibodies (DSA) at two mean fluorescence intensity (MFI) thresholds in recipients of an outpatient haplo-SCT.

Methods:

Seventy haplo-HCT recipients were analyzed. A virtual crossmatch was performed using the donor HLA typing and the recipient’s anti-HLA DSA test results. Data for anti-HLA-A, -B, -C, and -DR were analyzed. Recipients with DSA ≥ 500 MFI were considered positive, and those with < 500 were considered negative; the same was adopted for MFI ≥ 1000.

Results:

Post-transplant infection was higher in recipients with DSA ≥ 500 MFI (84.6%, p = 0.041). First-year mortality was higher in DSA-positive patients ≥ 500 MFI, p = 0.004, and DSA ≥ 1000 MFI, p = 0.022, than in DSA-negative recipients. Graft failure in the first 100 days was not associated with DSA ≥ 500 or ≥ 1000 MFI. There was no difference in acute (a-GVHD) or chronic (c-GVHD) graft versus host disease between DSA-positive and negative patients.

Conclusions:

There was no association of anti-HLA DSA at MFI ≥ 500 and ≥ 1000 with graft failure, however, increased infection and 1st-year mortality were documented in related haplo-HCT at the MFI cutoffs studied. (REV INVEST CLIN. 2023;75(5):249-58)

Keywords : Anti-HLA donor-specific antibodies; Graft failure; Haploidentical stem cell transplant; Mean fluorescence intensity; Single-antigen assay; Virtual crossmatch.

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