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Successful engraftment of a second transplant from unrelated cord blood identifying acceptable HLA Ag mismatches as treatment for primary graft failure possibly mediated by anti-HLA Abs after ‘mega-dose’ haploidentical PBSC transplantation

Bone Marrow Transplantation volume 45, pages 1665–1667 (2010)Cite this article

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Patients with preformed Abs are at increased risk of rejection after solid organ transplantation;1 however, the function of Ab-mediated rejection in hematopoietic SCT is still not completely understood. The use of sensitive solid-phase Ab detection assays, such as LABScreen (One Lambda, Canoga Park, CA, USA), which are based on flow cytometry, has enhanced our ability to detect and identify donor-specific anti-HLA Abs (DSA). LABScreen Single Antigen (One Lambda) had single recombinant HLA class I and class II Ag on each bead.

This report describes a patient with anti-HLA Abs who achieved successful engraftment after HLA-mismatched cord blood transplantation (CBT) due to primary graft failure after ‘mega-dose’ PBSC transplantation. Table 1 shows the anti-HLA Abs identified before treatment, and the HLA of the patient and the donors. We identify the epitopes with unique amino-acid positions according to the epitope analysis that was reported by Maruya et al.2

Table 1 Anti-HLA Abs before treatment, donors and recipient HLA
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Authors and Affiliations

  1. Leukemia Research Center, Saiseikai Maebashi Hospital, Maebashi, Gunma, Japan

    T Hoshino, T Sakura, K Miyawaki, N Hatsumi, S Takada & S Miyawaki

  2. HLA Laboratory, NPO, Kyoto, Kyoto, Japan

    E Maruya & H Saji

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  1. T Hoshino
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  2. T Sakura
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  3. K Miyawaki
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  4. N Hatsumi
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  5. S Takada
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  6. E Maruya
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  7. H Saji
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  8. S Miyawaki
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Correspondence to T Hoshino.

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Hoshino, T., Sakura, T., Miyawaki, K. et al. Successful engraftment of a second transplant from unrelated cord blood identifying acceptable HLA Ag mismatches as treatment for primary graft failure possibly mediated by anti-HLA Abs after ‘mega-dose’ haploidentical PBSC transplantation. Bone Marrow Transplant 45, 1665–1667 (2010). https://doi.org/10.1038/bmt.2010.30

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