Title :

Impact of donor-specific anti-HLA antibodies on graft failure and survival after reduced intensity conditioning-unrelated cord blood transplantation: a Eurocord, Société Francophone d'Histocompatibilité et d'Immunogénétique (SFHI) and Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC) analysis.

Author(s) :

Ruggeri, Annalisa [Auteur]
Université Paris Diderot - Paris 7 [UPD7]
Rocha, Vanderson [Auteur]
Université Paris Diderot - Paris 7 [UPD7]
Masson, Emeline [Auteur]
Centre d'Investigation Clinique de Besançon [Inserm CIC 1431]
Labopin, Myriam [Auteur]
CHU Saint-Antoine [AP-HP]
Cunha, Renato [Auteur]
Université Paris Diderot - Paris 7 [UPD7]
Absi, Lena [Auteur]
Etablissement français du sang, Auvergne-Loire [Saint-Etienne] [EFS]
Boudifa, Ali [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Coeffic, Brigitte [Auteur]
Laboratoire d'histocompatibilité et d'immunogénétique [Angers]
Devys, Anne [Auteur]
SImulations and Modeling for PArticles and Fluids [SIMPAF]
Laboratoire Paul Painlevé - UMR 8524 [LPP]
de Matteis, Muriel [Auteur]
Laboratoire d'histocompatibilité et d'immunogénétique [Angers]
Dubois, Valérie [Auteur]
Hanau, Daniel [Auteur]
Biologie des Cellules Dendritiques Humaines
Hau, Françoise [Auteur]
Etablissement français du sang - Normandie [EFS]
Jollet, Isabelle [Auteur]
Etablissement français du sang [Poitiers] [EFS]
Masson, Dominique [Auteur]
Etablissement français du sang - Auvergne-Rhône-Alpes [EFS]
Pedron, Beatrice [Auteur]
AP-HP Hôpital universitaire Robert-Debré [Paris]
Perrier, Pascale [Auteur]
Centre Hospitalier Régional Universitaire de Nancy [CHRU Nancy]
Picard, Christophe [Auteur]
Anthropologie bio-culturelle, Droit, Ethique et Santé [ADES]
Etablissement Français du Sang - Alpes-Méditerranée [EFS - Alpes-Méditerranée]
Ramouneau-Pigot, Annie [Auteur]
Hôpital Saint Eloi [CHU Montpellier]
Volt, Fernanda [Auteur]
Université Paris Diderot - Paris 7 [UPD7]
Charron, Dominique [Auteur]
Hématologie -Immunologie -Cibles thérapeutiques
Gluckman, Eliane [Auteur]
Loiseau, Pascale [Auteur]
Immunogénétique humaine

Journal title :

Haematologica

Pages :

1154-60

Publisher :

Ferrata Storti Foundation

Publication date :

2013-07

ISSN :

0390-6078

HAL domain(s) :

Sciences du Vivant [q-bio]
Sciences du Vivant [q-bio]/Immunologie

English abstract : [en]

Graft failure is a major complication after unrelated cord blood transplantation. Presence of HLA-antibodies before cord blood transplantation may impact graft failure. To analyze the effect of anti-HLA antibodies on ...
Show more >Graft failure is a major complication after unrelated cord blood transplantation. Presence of HLA-antibodies before cord blood transplantation may impact graft failure. To analyze the effect of anti-HLA antibodies on unrelated cord blood transplantation outcomes, we analyzed 294 unrelated cord blood transplant recipients after reduced intensity conditioning regimen. The majority of the patients (82%) were transplanted for malignancies, 60% with double-unrelated cord blood transplant, 63% were HLA mismatched. Retrospectively, pre-unrelated cord blood transplant serum was tested for HLA-Ab using Luminex™ platform. Results were interpreted as mean fluorescence intensity (MFI) against donor-specific mismatch. Among 62 recipients (23%) who had anti-HLA antibodies before unrelated cord blood transplant, 14 patients had donor specific anti-HLA antibodies (DSA) (7 were donor-specific anti-HLA antibodies for single unrelated cord blood transplant and 7 for double unrelated cord blood transplant). Donor specific anti-HLA antibodies threshold ranged from 1620-17629 of mean fluorescence intensity (MFI). Cumulative incidence of Day-60 neutrophil engraftment was 76%: 44% for recipients with donor specific anti-HLA antibodies and 81% in those without donor specific anti-HLA antibodies (P=0.006). The cumulative incidence of 1-year transplant related mortality was 46% in patients with donor specific anti-HLA antibodies and 32% in those without antibodies (P=0.06). The presence of donor specific anti-HLA antibodies was associated with a trend for decreased survival rate (42% vs. 29%; P=0.07). Donor specific anti-HLA antibody in recipients of unrelated cord blood transplant is associated with graft failure and decreased survival. Patient's screening for donor specific anti-HLA antibodies before unrelated cord blood transplantation is recommended before choosing an HLA mismatched cord blood unit. Whenever possible it is important to avoid selecting a unit for which the patient has donor specific anti-HLA antibodies.Show less >

Language :

Anglais

Popular science :

Non

Collections :

• Laboratoire Paul Painlevé - UMR 8524

Source :

Harvested from HAL