Late Graft Rejection in Association With T-Large Granular Lymphocyte Expansion of Recipient Origin After Human Leukocyte Antigen–Haploidentical Stem Cell Transplantation: A Case Report

2016 ◽  
Vol 48 (9) ◽  
pp. 3222-3224 ◽  
Author(s):  
N. Nakagawa ◽  
H. Yamazaki ◽  
G. Aoki ◽  
Y. Kondo ◽  
S. Nakao
Keyword(s):  
Stem Cell ◽  
Case Report ◽  
Stem Cell Transplantation ◽  
Human Leukocyte Antigen ◽  
Cell Transplantation ◽  
Graft Rejection ◽  
Human Leukocyte ◽  
Large Granular Lymphocyte ◽  
Leukocyte Antigen ◽  
Haploidentical Stem Cell Transplantation

Significance of a Single Human Leukocyte Antigen Mismatch on the Outcome of Nonmyeloablative Allogeneic Stem Cell Transplantation from Related Donors Using the Mexican Schedule.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 5182-5182
Author(s):  
Guillermo J. Ruiz-Arguelles ◽  
Briceida López-Martínez ◽  
Carlos Manzano ◽  
J. D. Gómez-Rangel
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Human Leukocyte Antigen ◽  
Cell Transplantation ◽  
Chronic Gvhd ◽  
Conditioning Regimen ◽  
Human Leukocyte ◽  
Leukocyte Antigen ◽  
Nonmyeloablative Stem Cell Transplantation ◽  
Number Of Patients

Abstract The Mexican approach was used to conduct nonmyeloablative stem cell transplantation (SCT) in patients with various malignant and non-malignant hematologic diseases. Patients received a modified, low-intensity conditioning regimen, which included oral busulphan 4 mg/kg on Days −6 and −5, IV cyclophosphamide 350 mg/m2 on Days −4, −3, and −2, IV fludarabine 30 mg/m2 on Days −4, −3, and −2, oral cyclosporine A 5 mg/kg twice daily staring on Day −1 (continuing until Day 180), and IV methotrexate 5 mg/m2 on Days +1, +3, +5, and +11. Allografts were prospectively performed in 58 patients using sibling donors that were either human leukocyte antigen (HLA) identical (6/6) or compatible with 1 mismatch (5/6). In allografts where the donor was an HLA identical sibling (n = 40), the median overall survival was 33 months compared to 8 months when the donor was an HLA compatible sibling (n = 18; P <.01). The 52-month survival was 47% versus 38% in patients receiving allografts from HLA-identical donors and HLA-compatible donors, respectively. The prevalence of acute graft-versus-host-disease (GVHD) was 57% versus 38%, the prevalence of chronic GVHD was 25% versus 11%, and the relapse rate was 45% versus 55% in patients receiving allografts from HLA-identical donors and HLA-compatible donors, respectively. Two patients failed to engraft; both were 5/6 matches. Despite a trend toward less favorable results in patients allografted from HLA compatible (5/6) siblings, most differences in outcome were not significant, likely due to the small number of patients in the study. These data suggest that nonmyeloablative SCT using the Mexican approach may be a valid option for individuals with either an HLA identical or HLA compatible sibling donor.

scholarly journals Donor-Specific Anti-Human Leukocyte Antigen Antibodies Predict Prolonged Isolated Thrombocytopenia and Inferior Outcomes of Haploidentical Hematopoietic Stem Cell Transplantation

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Xiaosu Zhao ◽  
Xiangyu Zhao ◽  
Mingrui Huo ◽  
Qiaozhen Fan ◽  
Xuying Pei ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Human Leukocyte Antigen ◽  
Cell Transplantation ◽  
Human Leukocyte ◽  
Hematopoietic Stem ◽  
Fluorescent Intensity ◽  
Leukocyte Antigen ◽  
Blood And Marrow Transplantation ◽  
First Time

Prolonged isolated thrombocytopenia (PT) after allogeneic stem cell transplantation (allo-SCT) has a great impact on transplant outcome. In this study, we performed a retrospective analysis to investigate the association of donor-specific anti-human leukocyte antigen (HLA) antibodies (DSAs) with PT in 394 patients who underwent unmanipulated haploidentical blood and marrow transplantation (HBMT). For HLA antibody positive samples with a median fluorescent intensity (MFI) > 500, DSAs were further examined. A total of 390 patients (99.0%) achieved sustained myeloid engraftment. Of the 394 cases tested, 45 (11.4%) were DSA positive. The cumulative incidence of PT in this cohort of patients was 9.9 ± 1.5%. The incidence of PT was higher in patients with a MFI ≥ 1000 compared with those with a MFI < 1000 (16.8 ± 6.4% versus 7.4 ± 1.4%,P=0.05). Multivariate analysis showed that the presence of DSAs (MFI ≥ 1000) was correlated to PT (hazard ratio (HR) 3.262; 95% confidence interval (CI), 1.339–7.946;P=0.009) and transplant-related mortality (HR 2.320; 95% CI, 1.169–4.426;P=0.044). Our results, for the first time, suggest an association of DSAs with PT after unmanipulated HBMT. It would help screen out the suitable donor and guide intervention. This indicated that DSAs should be incorporated in the algorithm for unmanipulated HBMT.

Sign in / Sign up

Export Citation Format

Share Document