The association of de novo anti-HLA-DPB1 donor-specific antibody formation and primary graft failure after allogeneic hematopoietic cell transplantation

Hum Immunol. 2018 Dec;79(12):861-864. doi: 10.1016/j.humimm.2018.08.009. Epub 2018 Aug 22.

Abstract

Despite advances in HLA matching, graft failure remains a serious complication after allogeneic hematopoietic cell transplantation (HCT). Pre-formed anti-HLA donor-specific antibodies (DSAs) have been associated with graft failure, but the impact of newly developing (de novo) anti-HLA antibodies on HCT outcomes remains unknown. Here, we present the first reported case of graft failure associated with de novo anti-HLA-DPB1 DSA after a 10/10 matched unrelated donor HCT. Based on this observation, testing for DSA should be considered in case of unexplained pancytopenia after allogeneic transplantation, especially after reduced intensity conditioning.

Keywords: Allogeneic; Donor Specific Antibody; Graft failure; Hematopoietic cell transplantation; Human Leukocyte Antigen.

Publication types

  • Case Reports

MeSH terms

  • Antibodies / immunology*
  • Antibody Specificity / immunology
  • Graft Rejection / etiology
  • Graft Rejection / immunology*
  • HLA-DP beta-Chains / immunology*
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Hematopoietic Stem Cell Transplantation / methods*
  • Histocompatibility Testing / methods
  • Humans
  • Male
  • Middle Aged
  • Tissue Donors*
  • Transplantation, Homologous

Substances

  • Antibodies
  • HLA-DP beta-Chains
  • HLA-DPB1 antigen