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.
Shigeo FujiKumi OshimaKazuteru OhashiMasashi SawaTakeshi SaitoTetsuya EtoMasatsugu TanakaMakoto OnizukaHirohisa NakamaeSouichi ShiratoriYukiyasu OzawaMichihiro HidakaTokiko Nagamura-InoueHidenori TanakaTakahiro FukudaTatsuo IchinoheYoshiko AtsutaMasao OgataPublished in: Bone marrow transplantation (2019)
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.