Impact of pretransplant donor-specific anti-HLA antibodies on cord blood transplantation on behalf of the Transplant Complications Working Group of Japan Society for Hematopoietic Cell Transplantation

• Published in: Bone marrow transplantation (Basingstoke) Vol. 55; no. 4; pp. 722 - 728
• Main Authors: Fuji, Shigeo, Oshima, Kumi, Ohashi, Kazuteru, Sawa, Masashi, Saito, Takeshi, Eto, Tetsuya, Tanaka, Masatsugu, Onizuka, Makoto, Nakamae, Hirohisa, Shiratori, Souichi, Ozawa, Yukiyasu, Hidaka, Michihiro, Nagamura-Inoue, Tokiko, Tanaka, Hidenori, Fukuda, Takahiro, Ichinohe, Tatsuo, Atsuta, Yoshiko, Ogata, Masao
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.04.2020; Nature Publishing Group
• Subjects: 631/67/1990; 692/700/565/2194; Antibodies; Blood; Cell Biology; Complications; Cord blood; Fetal blood; Fluorescence; Graft rejection; Grafts; Health aspects; Hematology; Histocompatibility antigen HLA; Histocompatibility antigens; HLA histocompatibility antigens; Immunoglobulins; Internal Medicine; Medicine; Medicine & Public Health; Public Health; Stem cell transplantation; Stem Cells; Transplantation; Transplants & implants; Japan
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/s41409-019-0712-0

Graft failure (GF) remains a major complication of cord blood transplantation (CBT). Although the presence of pretransplant, donor-specific anti-HLA antibodies (DSA) was reported to be associated with an increased risk of GF after CBT, data are still limited. Thus, we conducted a retrospective analysis of recipients of single-unit CBT with pretransplant anti-HLA antibodies using the database of Japan Society for Hematopoietic Cell Transplantation (JSHCT). Data for recipients of single-unit CBT with pretransplant anti-HLA antibodies from 2010 to 2014 were obtained. In total, 343 patients who received CBT and who had detailed information about anti-HLA antibodies were included. The median age was 51 years (range, 0–71). Regarding DSA, 25 patients had a mean fluorescence intensity (MFI) ≥ 1000 (DSA-positive group) and 318 patients had a MFI <1000 (DSA-negative group). The cumulative incidence of neutrophil engraftment at 60 days after CBT was 75.7% (95% CI, 70.6–80.1) in the DSA-negative group and 56.0% (95% CI, 34.1–73.1) in the DSA-positive group ( P  = 0.03). In conclusion, pretransplant DSA with a MFI ≥ 1000 was associated with an increased risk of GF in single-unit CBT.