Impact of Donor-Specific anti-HLA antibodies and donor KIR characteristics in  haploidentical HSCT for beta-Thalassemia

Andreani, Marco; Testi, Manuela; Sodani, Pietro; Troiano, Maria; Luzio, Andrea Di; Testa, Giuseppe; Falco, Michela; Poggi, E.; Gaziev, Javid; Piazza, A.

doi:10.4084/mjhid.2017.020

Cited by 5 publications

(4 citation statements)

References 16 publications

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“…Although patients with DSAs had a higher rate of graft failure than patients who did not have DSAs, this was not statistically significant, likely because of the small sample size and unrecognized DSAs. 19 Remarkably, in CD34 group, 4 of 10 patients (40%) who were negative for DSAs had rejection, which supports our hypothesis that graft content plays an important role in promoting engraftment in T-cell-depleted haplo-HCT in patients with hemoglobinopathies. The high sustained engraftment rate in patients treated with TCRab 1 /CD19 1 -depleted grafts translated into a higher DFS rate (69%) compared with patients given CD34 1 -selected grafts, although it was not statistically significant because of the small number of patients.…”

supporting

confidence: 70%

“…In a retrospective analysis of 13 CD34 group patients (6 patients with sustained engraftment and 7 patients with graft failure), we investigated anti-HLA antibodies. 19 Anti-HLA antibodies were identified in 5 (38%) patients. Three of these patients also had DSAs ( Table 2).…”

Section: Tcrabmentioning

confidence: 99%

“…In a retrospective analysis of 5 patients whose pretransplant serum samples were available, we investigated anti-HLA antibodies. 19 Among these patients, 1 who had graft failure was positive for anti-HLA antibodies, but not for donor-specific antibodies (DSAs) ( Table 2). All patients with sustained engraftment had complete donor chimerism.…”

Section: Tcrabmentioning

confidence: 99%

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Haploidentical HSCT for hemoglobinopathies: improved outcomes with TCRαβ+/CD19+-depleted grafts

et al. 2018

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Key Points• TCRab 1 /CD19 1 -depleted haplo-HCT is associated with a reduced incidence of graft failure in patients with hemoglobinopathies.• The major challenges of haplo-HCT in hemoglobinopathies are delayed immune reconstitution and associated morbidity and mortality.We examined outcomes of haploidentical hematopoietic cell transplantation (haplo-HCT) using hydroxyurea, and azathioprine. The median follow-up among surviving patients was 3.9 years.The 5-year probabilities of overall survival (OS) and disease-free survival (DFS) were 84% and 69%, respectively. The incidence of graft failure was 14%. We compared outcomes to a historical group of 40 patients with hemoglobinopathies who received CD34 1 -selected grafts (CD34 group). The median follow-up of surviving patients for the CD34 group was 7.5 years. The 5-year probabilities of OS and DFS were 78% and 39%, respectively. The CD34 group had a significantly higher incidence of graft failure (45%) than the TCR group (14%) (P 5 .048). The incidences of grades 2 to 4 acute graft-versus-host disease (GVHD) in the TCR and CD34 groups were 28% and 29%, respectively, and 21% and 10% (P 5 .1), respectively, for extensive chronic GVHD. Viral reactivation was common in both groups. The overall incidence of posttransplant lymphoproliferative disorders for the entire group was 16%. Among all patients, 5 developed autoimmune hemolytic anemia or thrombocytopenia, with the overall cumulative incidence of 11%. The 2 groups showed suboptimal CD4 1 recovery within the first 6 months of transplantation with no significant difference between groups. These data demonstrate that TCRab 1 /CD19 1 -depleted grafts are associated with a reduced incidence of graft failure, but delayed immune reconstitution and associated morbidity and mortality remain a significant challenge.

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confidence: 70%

Section: Tcrabmentioning

confidence: 99%

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Haploidentical HSCT for hemoglobinopathies: improved outcomes with TCRαβ+/CD19+-depleted grafts

et al. 2018

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“…However, in reality a human leucocyte antigen (HLA)‐matched donor can be found for only 20–30% of thalassaemia major patients (Shenoy & Thompson, 2016). In recent decades, HLA‐haploidentical HSCT has been increasingly performed for haematological malignancies (Andreani et al , 2017), but the experience is limited for thalassaemia major. To date, only a few small cohort studies have been reported (La Nasa et al , 2002; Sodani et al , 2010; Anurathapan et al , 2016).…”

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Haploidentical haematopoietic stem cell transplantation for thalassaemia major based on an FBCA conditioning regimen

Sun

Lan

et al. 2018

Br J Haematol

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SummaryAllogeneic haematopoietic stem cell transplantation (HSCT) is the only available curative therapy for patients with thalassaemia major. With the progress in human leucocyte antigen (HLA) antigen typing technology and supportive care, the outcomes of thalassaemia major have greatly improved in recent years, even in high‐risk patients. However, the problem of finding a suitable donor is still a major obstacle to curing these patients. In recent decades, the lack of available HSCT donors has led to the increased use of haploidentical donors (HDs) for HSCT in haematological malignancies. Recently, we explored the effect of HD HSCT to eight children with thalassaemia major based on the FBCA conditioning regimen (fludarabine, busulphan, cyclophosphamide, antithymocyte globulin), which is usually used in leukaemia patients receiving haploidentical HSCT in our centre. So far, all of the transplanted patients have a stable engraftment and are transfusion independent in daily life. This encouraging result has revised our previous conception about haploidentical HCST for thalassaemia major and strongly suggests that HD HSCT is a feasible and safe method for thalassaemia major patients.

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A Single Centre Experience of Effective Desensitization Strategy for Children with High Anti-HLA Donor-Specific Antibodies Undergoing Haploidentical Hematopoietic Stem Cell Transplantation

Kumar¹,

Bharadwaj²,

Sachan³

et al. 2023

Indian J Hematol Blood Transfus

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Impact of Donor-Specific anti-HLA antibodies and donor KIR characteristics in haploidentical HSCT for beta-Thalassemia

Cited by 5 publications

References 16 publications

Haploidentical HSCT for hemoglobinopathies: improved outcomes with TCRαβ+/CD19+-depleted grafts

Haploidentical HSCT for hemoglobinopathies: improved outcomes with TCRαβ+/CD19+-depleted grafts

Haploidentical haematopoietic stem cell transplantation for thalassaemia major based on an FBCA conditioning regimen

A Single Centre Experience of Effective Desensitization Strategy for Children with High Anti-HLA Donor-Specific Antibodies Undergoing Haploidentical Hematopoietic Stem Cell Transplantation

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