دورية أكاديمية
أعرض في EDS

Successful desensitization of high level donor-specific anti-HLA antibody in patients with hematological diseases receiving haploidentical allografts.

التفاصيل البيبلوغرافية
العنوان: Successful desensitization of high level donor-specific anti-HLA antibody in patients with hematological diseases receiving haploidentical allografts.
المؤلفون: Zheng X; Department of Hematology, Air Force Medical Center, PLA, Beijing, China., Yan H; Department of Hematology, Air Force Medical Center, PLA, Beijing, China., Han D; Department of Hematology, Air Force Medical Center, PLA, Beijing, China., Ding L; Department of Hematology, Air Force Medical Center, PLA, Beijing, China., Zhu L; Department of Hematology, Air Force Medical Center, PLA, Beijing, China., Liu J; Department of Hematology, Air Force Medical Center, PLA, Beijing, China., Xue M; Department of Hematology, Air Force Medical Center, PLA, Beijing, China., Li S; Department of Hematology, Air Force Medical Center, PLA, Beijing, China., Wang H; Department of Hematology, Air Force Medical Center, PLA, Beijing, China. hematology123@163.com.
المصدر: Annals of hematology [Ann Hematol] 2022 Aug; Vol. 101 (8), pp. 1777-1783. Date of Electronic Publication: 2022 Jun 21.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer Verlag Country of Publication: Germany NLM ID: 9107334 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-0584 (Electronic) Linking ISSN: 09395555 NLM ISO Abbreviation: Ann Hematol Subsets: MEDLINE
أسماء مطبوعة: Publication: Berlin : Springer Verlag
Original Publication: Berlin ; New York : Springer International, c1991-
مواضيع طبية MeSH: Graft vs Host Disease*/drug therapy , Graft vs Host Disease*/etiology , Graft vs Host Disease*/prevention & control , Hematologic Diseases*/drug therapy, Allografts ; Graft Rejection/prevention & control ; Graft Survival ; HLA Antigens ; Humans ; Immunoglobulins, Intravenous/therapeutic use ; Rituximab/therapeutic use
مستخلص: Donor-specific anti-human leukocyte antigen (HLA) antibody (DSA) is associated with a higher incidence of graft failure and mortality in HLA-mismatched allograft settings. However, the optimal protocol of desensitization for patients with positive DSA remains uncertain. We investigated the effectiveness of a desensitization protocol, including rituximab, high-dose intravenous immunoglobulin (IVIG), and a single session of plasma exchange (PE), for haploidentical allograft recipients with a high mean fluorescence intensity (MFI) level of DSA (≥ 5,000). Eleven patients with hematological disease who had positive DSA (median, 11,676, range 5387-20,435) were desensitized by the protocol. All of the patients achieved hematopoietic recovery. The median times for neutrophil and platelet engraftment were 13 (range, 11-26) days and 19 (range, 11-90) days, respectively. Grade II-IV acute graft-versus-host disease (GVHD) was seen in one patient and was controlled completely. Chronic cutaneous GVHD was seen in eight patients. Nine patients are alive with good performance so far. One patient suffered extramedullary relapse, and one patient died of transplantation-associated thrombotic microangiopathy. The 1-year probability of overall survival was 81.8%. These results suggest that successful desensitization could be obtained by a combination of rituximab, high-dose IVIG, and PE for haploidentical allograft recipients with high MFI levels of DSA.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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معلومات مُعتمدة: 2014-2-5122 Capital Foundation of Medical Development
فهرسة مساهمة: Keywords: Desensitization procedure; Donor-specific anti-HLA antibodies; Engraftment; Plasma exchange; Rituximab
المشرفين على المادة: 0 (HLA Antigens)
0 (Immunoglobulins, Intravenous)
4F4X42SYQ6 (Rituximab)
تواريخ الأحداث: Date Created: 20220621 Date Completed: 20220715 Latest Revision: 20220715
رمز التحديث: 20231215
DOI: 10.1007/s00277-022-04844-5
PMID: 35726105
قاعدة البيانات: MEDLINE
الوصف
تدمد:1432-0584
DOI:10.1007/s00277-022-04844-5