Sustained donor engraftment in recipients of double-unit cord blood transplantation is possible despite donor-specific human leukoctye antigen antibodies Journal Article
| Authors: | Dahi, P. B.; Barone, J.; Devlin, S. M.; Byam, C.; Lubin, M.; Ponce, D. M.; Giralt, S.; Kernan, N. A.; Scaradavou, A.; Hsu, S. H.; Barker, J. N. |
| Article Title: | Sustained donor engraftment in recipients of double-unit cord blood transplantation is possible despite donor-specific human leukoctye antigen antibodies |
| Abstract: | The impact of human leukocyte antigen (HLA) donor-specific antibodies (DSA) on cord blood (CB) engraftment is controversial. We evaluated the influence of pre-existing HLA-antibodies (HLA-Abs) on engraftment in 82 double-unit CB recipients (median age, 48 years) who underwent transplantation for hematologic malignancies. Of 28 patients (34%) with HLA-Abs, 12 had DSA (median mean fluorescence intensity 5255; range, 1057 to 9453). DSA patients had acute leukemia (n= 11) or myelodysplasia (n= 1) and all received either high-dose or reduced-intensity (but myeloablative) conditioning. After myeloablative CB transplantation (CBT) (n= 67), sustained donor engraftment was observed in 95% without HLA-Abs (median, 23 days), 100% with nonspecific HLA-Abs (median, 23 days), and 92% with DSA (median, 31 days, P=.48). Of 6 patients with HLA-Abs to 1 unit, 3 engrafted with that unit and 3 with the other. Of 6 patients with HLA-Abs against both units, 1 had graft failure despite being 100% donor, and 5 engrafted with 1 unit. Successful donor engraftment is possible in patients with DSA after myeloablative double-unit CBT. Our data suggest potential deleterious effects of DSA can be abrogated in patients with hematologic malignancies. © 2014 American Society for Blood and Marrow Transplantation. |
| Keywords: | engraftment; cord blood transplantation; human leukocyte antigen (hla) antibodies |
| Journal Title: | Biology of Blood and Marrow Transplantation |
| Volume: | 20 |
| Issue: | 5 |
| ISSN: | 1083-8791 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2014-05-01 |
| Start Page: | 735 |
| End Page: | 739 |
| Language: | English |
| DOI: | 10.1016/j.bbmt.2014.01.017 |
| PROVIDER: | scopus |
| PMCID: | PMC3984623 |
| PUBMED: | 24462980 |
| DOI/URL: | |
| Notes: | Export Date: 1 May 2014 -- CODEN: BBMTF -- Source: Scopus |
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