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Effective desensitization for a strong donor‐specific HLA antibody in a case of HLA‐mismatched allogeneic hematopoietic cell transplantation
Author(s) -
Misra Maneesh K.,
Xin John J.,
Brown Nicholas K.,
Weidner Jerome G.,
Upchurch Rebecca L.,
Bishop Michael R.,
Wool Geoffrey D.,
Artz Andrew S.,
Marino Susana R.
Publication year - 2019
Publication title -
hla
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.347
H-Index - 99
eISSN - 2059-2310
pISSN - 2059-2302
DOI - 10.1111/tan.13627
Subject(s) - desensitization (medicine) , human leukocyte antigen , abo blood group system , transplantation , medicine , immunology , histocompatibility testing , donor specific antibodies , hematopoietic stem cell transplantation , hematopoietic cell , haematopoiesis , antigen , stem cell , biology , genetics , receptor
We describe a unique ABO compatible and 9/10 HLA‐matched case of successful allogeneic hematopoietic cell transplantation (HCT) after effective desensitization of a strong anti‐HLA‐A24 donor‐specific antibody (DSA) with mean fluorescence intensity of approximately 18 000. Due to absence of a suitable matched unrelated donor the patient sibling was considered the best available donor, and it was decided to desensitize patient prior to transplant. The strength of HLA‐A24 DSA slowly decreased over the course of treatment, necessitating a total of 23 sessions of therapeutic plasma exchange in order to bring the DSA strength to undetectable levels, followed by a successful transplant. In summary, the outcome of this case shows effective application of desensitization treatment to remove strong DSA in HCT patients.