Abrogation of Anti-HLA Antibodies via Proteasome Inhibition

Trivedi, Hargovind L; Terasaki, Paul I.; Aziz, Feroz; Everly, Matthew J; Vanikar, Aruna V; Shankar, Vangipurapu; Trivedi, Varsha B; Kaneku, Hugo; Idica, Adam; Modi, Pranjal; Khemchandani, Sajani I.; Dave, Shruti D

doi:10.1097/tp.0b013e3181a4b91b

Cited by 154 publications

(129 citation statements)

References 28 publications

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“…20 In addition, bortezomib has received recent attention in studies showing that it directly eliminates Ab-producing plasma cells and thus prevents Ab-mediated graft rejection after renal transplantation. [21][22][23] Moreover, improvement of platelet transfusion refractoriness was observed in a patient with HLA class I antibodies with the treatment of bortezomib for multiple myeloma. 24 The effectiveness of high-dose i.v.…”

Section: Discussionmentioning

confidence: 99%

Risk and prevention of graft failure in patients with preexisting donor-specific HLA antibodies undergoing unmanipulated haploidentical SCT

Yoshihara

Maruya²,

Taniguchi

et al. 2011

Bone Marrow Transplant

202

201

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A role of donor-specific HLA antibodies (DSA) in graft failure after SCT has been suggested, but the relevance of DSA in unmanipulated haploidentical SCT (haplo-SCT) remains unknown. We prospectively examined HLA antibodies using the Luminex-based single Ag assay for 79 adult patients undergoing unmanipulated haplo-SCT. Among them, 16 (20.2%) were HLA Ab-positive, including five patients with antibodies not corresponding to donor HLA Ags and 11 DSA-positive patients. Of the 11 DSA-positive patients, five received treatments to decrease DSA levels, including two, who received plasma exchange and rituximab, two who received platelet transfusions from healthy-related donors having DSAcorresponding HLA Ags and one who received bortezomib. Platelet transfusion was the most simple and effective treatment option for class I DSA. The cumulative incidence of neutrophil recovery was significantly lower in pretransplant (post-treatment) DSA-positive patients than in DSA-negative patients (61.9 vs 94.4%, P ¼ 0.026). Notably, three of five patients with high levels of DSA had graft failure. Donors should be selected on the basis of an evaluation of HLA antibodies. If haplo-SCT from donors with HLA Ags that correspond to high levels of DSA must be performed, then recipients should be treated for DSA to improve the chances of successful donor engraftment.

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Section: Discussionmentioning

confidence: 99%

Risk and prevention of graft failure in patients with preexisting donor-specific HLA antibodies undergoing unmanipulated haploidentical SCT

Yoshihara

Maruya²,

Taniguchi

et al. 2011

Bone Marrow Transplant

202

201

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show abstract

“…Bortezomib has been successfully used to decrease DSA levels, which may play a role in acute antibody-mediated rejection (AMR) www.intechopen.com (Trivedi et al, 2009). Furthermore, in vivo data has demonstrated a decrease in the percentage of bone marrow plasma cells, antibody production, and allospecificities of plasma cells in bone marrow aspirates of patients treated with bortezomib i in the setting of AMR (Perry et al, 2009).…”

Section: Applicationsmentioning

confidence: 99%

Induction Therapy in Renal Transplant Recipients

Afaneh¹,

Aull²,

Kapur³

et al. 2012

Immunosuppression - Role in Health and Diseases

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“…Its application in the field of transplantation is relatively new and based upon both in vitro and in vivo evidence of its activity against plasma cells. This agent is now being used to attempt reduction of DSA in sensitized patients [92,93]. While many centers have incorporated this agent into treatment of AMR [94][95][96], its use for immunomodulation is limited to case reports.…”

Section: Future Of Crossmatch Incompatible Donorsmentioning

confidence: 99%