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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

Bone Marrow Transplantation volume 55, pages 722–728 (2020)Cite this article

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Abstract

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.

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Acknowledgements

This study was supported by Health, Labour and Welfare Science Grants for Research on Measures for Rare and Intractable Diseases from the Japanese Government.

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Authors and Affiliations

  1. Department of Hematology, Osaka International Cancer Institute, Osaka, Japan

    Shigeo Fuji

  2. Department of Hematology, Jyoban Hospital, Fukushima, Japan

    Kumi Oshima

  3. Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan

    Kazuteru Ohashi

  4. Department of Hematology and Oncology, Anjo Kosei Hospital, Aichi, Japan

    Masashi Sawa

  5. Oncology and Hematology, The Jikei University School of Medicine, Tokyo, Japan

    Takeshi Saito

  6. Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan

    Tetsuya Eto

  7. Department of Hematology, Kanagawa Cancer Center, Kanagawa, Japan

    Masatsugu Tanaka

  8. Department of Hematology and Oncology, Tokai University School of Medicine, Kanagawa, Japan

    Makoto Onizuka

  9. Department of Hematology, Osaka City University Hospital, Osaka, Japan

    Hirohisa Nakamae

  10. Department of Hematology, Hokkaido University Hospital, Sapporo, Japan

    Souichi Shiratori

  11. Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    Yukiyasu Ozawa

  12. Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan

    Michihiro Hidaka

  13. Department of Cell Processing and Transfusion, Institute of Medical Science, University of Tokyo, Tokyo, Japan

    Tokiko Nagamura-Inoue

  14. HLA Laboratory, Kyoto, Japan

    Hidenori Tanaka

  15. Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan

    Takahiro Fukuda

  16. Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan

    Tatsuo Ichinohe

  17. Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Yoshiko Atsuta

  18. Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan

    Yoshiko Atsuta

  19. Department of Hematology, Oita University Hospital, Oita, Japan

    Masao Ogata

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  1. Shigeo Fuji
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  2. Kumi Oshima
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  3. Kazuteru Ohashi
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Contributions

SF, KO and MO designed the research, analyzed data, and wrote the paper. KO, MS, TS, TE, MT, MO, HN, SS, YO, MH, TN-I, HT, TF provided data. All authors have read the manuscript and consented to submission.

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Correspondence to Shigeo Fuji.

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Fuji, S., Oshima, K., Ohashi, K. et al. 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. Bone Marrow Transplant 55, 722–728 (2020). https://doi.org/10.1038/s41409-019-0712-0

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