首页> 外文期刊>Clinical & developmental immunology. >Donor-Specific Anti-Human Leukocyte Antigen Antibodies Predict Prolonged Isolated Thrombocytopenia and Inferior Outcomes of Haploidentical Hematopoietic Stem Cell Transplantation
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Donor-Specific Anti-Human Leukocyte Antigen Antibodies Predict Prolonged Isolated Thrombocytopenia and Inferior Outcomes of Haploidentical Hematopoietic Stem Cell Transplantation

机译:供体特异性抗人类白细胞抗原抗体可预测长期分离的血小板减少症和单倍型造血干细胞移植的不良结果

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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?
机译:同种异体干细胞移植(allo-SCT)后长时间的孤立性血小板减少症(PT)对移植结果有很大影响。在这项研究中,我们进行了一项回顾性分析,以调查394例接受未经处理的单倍体血液和骨髓移植(HBMT)的患者中,供体特异性抗人白细胞抗原(HLA)抗体(DSA)与PT的关联。对于中值荧光强度(MFI)≥500的HLA抗体阳性样品,应进一步检查DSA。共有390名患者(99.0%)实现了持续的骨髓植入。在测试的394例病例中,有45例(11.4%)为DSA阳性。在这组患者中,PT的累积发生率为9.9±1.5%。 MFI≥1000的患者的PT发生率高于MFI≥1000的患者(16.8±6.4%,7.4±1.4%,P = 0.05)。多变量分析表明,DSA(MFI≥1000)的存在与PT(危险比(HR)3.262; 95%置信区间(CI),1.339–7.946; P = 0.009)和移植相关死亡率(HR)相关。 2.320; 95%CI,1.169-4.426; P = 0.044)。我们的结果首次表明,未经操作的HBMT后将DSA与PT关联。这将有助于筛选出合适的捐助者并指导干预。这表明,DSA应该合并到未操作的HBMT算法中。

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