Premium
Pre‐existing anti‐ HLA antibodies negatively impact survival of pediatric aplastic anemia patients undergoing HSCT
Author(s) -
Zhu Hua,
He Jun,
Cai Junchao,
Yuan Xiaoni,
Jiang Hua,
Luo Changying,
Wang Jianmin,
Luo Chengjuan,
Pan Zhijuan,
Terasaki Paul I.,
Ding Lixia,
Chen Jing
Publication year - 2014
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12450
Subject(s) - medicine , aplastic anemia , antibody , human leukocyte antigen , hematopoietic stem cell transplantation , immunology , anemia , transplantation , gastroenterology , antigen , bone marrow
Graft failure and survival are the major problems for patients with aplastic anemia undergoing hematopoietic stem cell transplantation ( HSCT ). Previous studies showed that anti‐ HLA antibodies negatively impact engraftment in HSCT . This retrospective study of 51 pediatric patients with acquired aplastic anemia who underwent allogeneic HSCT at a single institution between 2006 and 2012 investigated the influence of anti‐ HLA antibodies on the outcome of HSCT . Serum samples collected before HSCT were tested for the presence of anti‐ HLA antibodies. Pre‐existing anti‐ HLA antibodies were detected in 54.9% (28/51) of patients, among whom 39.2% (20/51) had anti‐ HLA class I antibodies. Anti‐ HLA antibodies were associated with worse five‐yr survival (78.6% vs. 100%, p = 0.021) and higher treatment‐related mortality (21.4% vs. 0%, p = 0.028) compared with antibody‐negative patients. Anti‐ HLA class I antibody‐positive patients had poorer five‐yr survival (75.0%) than anti‐ HLA class I& II antibody‐positive and antibody‐negative patients (87.5% and 100.0%, respectively, p = 0.039). Presence of anti‐ HLA class I antibodies (p = 0.024) and older age (10 yr or more; p = 0.027) significantly increased the risk of post‐ HSCT mortality. Pre‐existing anti‐ HLA antibodies negatively affect the outcome of HSCT in pediatric patients with aplastic anemia. Routine testing for anti‐ HLA antibodies concurrent with efficient treatment should be conducted prior to HSCT .