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“Incidence and significance of donor-specific antibodies in haploidentical stem cell transplantation”

Bone Marrow Transplantation volume 58, pages 680–686 (2023)Cite this article

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Abstract

PGF is a devastating complication after allogeneic transplant. We retrospectively analyzed our haploidentical transplant registry to report the incidence and impact of DSA and anti-HLA on engraftment. 107 patients were identified. Median recipient-age of 22, median donor-age of 31. Sixty-two patients had AML (58%), 29 had ALL (27%), 16 (15%) had other malignancies. Sixty-one recipients (57%) had positive anti-HLA, 56 of them had the DSA results available, of these 17 patients had DSAs (15% of the total number of patients, or 28% of patients who have anti-HLA antibodies). The median cumulative MFI was 2062. Sixty-three percent of the DSA were against class-II HLA antigens. The OS, CIR, aGvHD, and cGvHD did not differ between patients with and without anti-HLA antibodies, nor between patients with and without DSA. The gender of the recipient and donor, as well as the gender mismatch between recipient and donor, were statistically associated with the incidence of anti-HLA antibodies. Three patients only developed GF (2.8%), one was primary (0.9%) and the other two secondary GF (1.9%). None of the GF cases was in patients with anti-HLA antibodies or DSA. The presence of anti-HLA or DSAs did not affect the outcomes including the incidence of PGF.

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Fig. 1: Overall survival and cumulative incidence of relapse of the whole group, patients with and without anti-HLA and patients with and without DSAs.
Fig. 2: The cumulative incidence of aGvHD and cGvHD of the whole group, patients with and without anti-HLA and patients with and without DSAs.

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Data availability

Raw data were generated at King Faisal Specialist Hospital and Research Center, Riyadh, KSA. Derived data supporting the findings of this study are available from the corresponding author [RE] upon request.

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Authors and Affiliations

  1. King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

    Majed Altareb, Moheeb Al-Awwami, Feras Alfraih, Saud Alhayli, Syed Osman Ahmed, Marwan Shaheen, Naeem Chaudhri, Fahad Alsharif, Abdulwahab A. Albabtain, Mansour Alfayez, Amr Hanbali, Alfadel Alshaibani, Ahmad S. Alotaibi, Walid Rasheed, Amal Algharably, Fahad Almohareb, Ali Alahmari, Hazzaa Alzahrani, Mahmoud Aljurf & Riad El Fakih

  2. Elm University College of Pharmacy, Riyadh, Saudi Arabia

    Hana Alkhabbaz

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Contributions

RE, MAA, and MA designed and performed the research, TE analyzed the data. RE wrote the first draft. All the co-authors revised and approved the final paper.

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Correspondence to Riad El Fakih.

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Altareb, M., Al-Awwami, M., Alfraih, F. et al. “Incidence and significance of donor-specific antibodies in haploidentical stem cell transplantation”. Bone Marrow Transplant 58, 680–686 (2023). https://doi.org/10.1038/s41409-023-01950-4

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