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Successful autologous hematopoietic progenitor cell transplantation in a patient with an isoantibody against CD36 (glycoprotein IV, Naka)

Bone Marrow Transplantation volume 42, pages 489–491 (2008)Cite this article

Refractoriness to platelet transfusions in patients undergoing myeloablative conditioning with consecutive hematopoietic progenitor cell transplantation represents a major clinical problem especially in patients with immunization against frequent antigens. Platelet glycoprotein (GP) IV (=CD36) is expressed in nearly 100% of white Europeans, while 2 to 11 percent of Asian and sub-Sahara African individuals are negative.1, 2, 3 CD36 deficiency appears not to be associated with clinical symptoms. Lack of CD36 can present as type I deficiency with neither platelets nor monocytes expressing CD36 and type II deficiency with only platelets lacking GPIV.4 Antibodies to CD36 developing after isoimmunization in type I deficiency can lead to serious complications such as platelet transfusion refractoriness, post transfusion purpura or neonatal alloimmune thrombocytopenia.5 Here the case of a patient from Oman admitted for HPC transplantation with an aggressive Non-Hodgkin's lymphoma and refractoriness to platelet transfusions caused by a GPIV isoantibody is reported.

The molecular background of CD36 type I deficiency has been described for some individuals and ranged from single-nucleotide exchanges to absence of exons 1–3.5, 7 In our patient, exons 1–14 could be amplified completely by PCR. Cloning (TA Cloning Kit with vector pCR2.1; Invitrogen, Paisley, UK) and sequencing (ABI 3730 XL; PE Applied Biosystems, Weiterstadt, Germany) of the 14 exons from genomic DNA showed no variation of the patient DNA compared to DNA of a GPIV-positive control donor and sequences from the National Center for Biotechnology Information databases. Therefore, variations of the genomic DNA cannot serve as an explanation for the GPIV type I deficiency in this patient and regulatory or transcriptional factors are more likely.

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Authors and Affiliations

  1. Institute of Transfusion Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany

    B Flesch & J Miller

  2. Second Department of Medicine, Section of Stem Cell Transplantation and Immunotherapy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany

    R Repp, B Gahn, N Schub, M Gramatzki & A Humpe

  3. Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany

    S Ott

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  1. B Flesch
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  2. J Miller
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  6. N Schub
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  8. A Humpe
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Correspondence to B Flesch.

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Flesch, B., Miller, J., Repp, R. et al. Successful autologous hematopoietic progenitor cell transplantation in a patient with an isoantibody against CD36 (glycoprotein IV, Naka). Bone Marrow Transplant 42, 489–491 (2008). https://doi.org/10.1038/bmt.2008.190

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