PMID- 20089963
OWN - NLM
STAT- MEDLINE
DCOM- 20100503
LR  - 20211020
IS  - 1528-0020 (Electronic)
IS  - 0006-4971 (Print)
IS  - 0006-4971 (Linking)
VI  - 115
IP  - 13
DP  - 2010 Apr 1
TI  - The detection of donor-directed, HLA-specific alloantibodies in recipients of 
      unrelated hematopoietic cell transplantation is predictive of graft failure.
PG  - 2704-8
LID - 10.1182/blood-2009-09-244525 [doi]
AB  - Donor-directed human leukocyte antigen (HLA)-specific allo-antibodies (DSAs) 
      cause graft failure in animal models of hematopoietic stem cell transplantation 
      (HCT). Archived pretransplantation sera from graft failure patients (n = 37) and 
      a matched case-control cohort (n = 78) were tested to evaluate the role of DSAs 
      in unrelated donor HCT. Controls were matched for disease, disease status, graft 
      type, patient age, and transplantation year. Patients had acute myeloid leukemia, 
      acute lymphoblastic leukemia, chronic myelogenous leukemia, or myelodysplastic 
      syndrome; 98% received myeloablative conditioning regimens 100% received 
      T-replete grafts, 97% received marrow, 95% HLA-mismatched, and 97% received 
      calcineurin-based graft-versus-host disease prophylaxis. Among the 37 failed 
      transplantations, 9 (24%) recipients possessed DSAs against HLA-A, B, and/or DP, 
      compared with only 1 (1%) of 78 controls. Therefore, the presence of DSAs was 
      significantly associated with graft failure (odds ratio = 22.84; 95% confidence 
      interval, 3.57-infinity; P < .001). These results indicate that the presence of 
      pretransplantation DSAs in recipients of unrelated donor HCT is associated with 
      failed engraftment and should be considered in HCT donor selection.
FAU - Spellman, Stephen
AU  - Spellman S
AD  - National Marrow Donor Program, Minneapolis, MN 55413, USA. sspellma@nmdp.org
FAU - Bray, Robert
AU  - Bray R
FAU - Rosen-Bronson, Sandra
AU  - Rosen-Bronson S
FAU - Haagenson, Michael
AU  - Haagenson M
FAU - Klein, John
AU  - Klein J
FAU - Flesch, Susan
AU  - Flesch S
FAU - Vierra-Green, Cynthia
AU  - Vierra-Green C
FAU - Anasetti, Claudio
AU  - Anasetti C
LA  - eng
GR  - U01 HL069294/HL/NHLBI NIH HHS/United States
GR  - U24 CA076518/CA/NCI NIH HHS/United States
GR  - U24-CA76518/CA/NCI NIH HHS/United States
GR  - 5U01HL069294/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20100120
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 0 (HLA Antigens)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Case-Control Studies
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Graft Rejection/*immunology
MH  - Graft vs Host Disease/prevention & control
MH  - HLA Antigens/*immunology
MH  - *Hematopoietic Stem Cell Transplantation
MH  - Histocompatibility
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Isoantibodies/*blood/immunology
MH  - Leukemia/immunology/surgery
MH  - Male
MH  - Middle Aged
MH  - Myelodysplastic Syndromes/immunology/surgery
MH  - Preoperative Care
MH  - Prognosis
MH  - Retrospective Studies
MH  - *Tissue Donors
MH  - Transplantation Conditioning
MH  - Transplantation, Homologous
MH  - Young Adult
PMC - PMC2852369
EDAT- 2010/01/22 06:00
MHDA- 2010/05/04 06:00
PMCR- 2011/04/01
CRDT- 2010/01/22 06:00
PHST- 2010/01/22 06:00 [entrez]
PHST- 2010/01/22 06:00 [pubmed]
PHST- 2010/05/04 06:00 [medline]
PHST- 2011/04/01 00:00 [pmc-release]
AID - S0006-4971(20)56571-3 [pii]
AID - 2009/244525 [pii]
AID - 10.1182/blood-2009-09-244525 [doi]
PST - ppublish
SO  - Blood. 2010 Apr 1;115(13):2704-8. doi: 10.1182/blood-2009-09-244525. Epub 2010 
      Jan 20.