PMID- 20628152
OWN - NLM
STAT- MEDLINE
DCOM- 20101105
LR  - 20210206
IS  - 1528-0020 (Electronic)
IS  - 0006-4971 (Linking)
VI  - 116
IP  - 15
DP  - 2010 Oct 14
TI  - The impact of anti-HLA antibodies on unrelated cord blood transplantations.
PG  - 2839-46
LID - 10.1182/blood-2009-10-249219 [doi]
AB  - The majority of cord blood transplantations (CBTs) have human leukocyte antigen 
      (HLA) disparities. We investigated the impact that patients' pretransplantation 
      anti-HLA antibodies have on the outcome of CBTs. Testing for anti-HLA antibody 
      and its specificity was performed retrospectively at the Japanese Red Cross Tokyo 
      Blood Center with sensitive solid-phase antibody detection assays. Among 386 
      CBTs, which were first myeloablative stem cell transplantations for malignancies 
      and used a single unit of cord blood, 89 tested positive. Among the 
      antibody-positive group, the cord blood did not have the corresponding HLA type 
      for the antibody in 69 cases (ab-positive), while 20 cases had specificity 
      against the cord blood HLA (positive-vs-CB). Cumulative incidence of neutrophil 
      recovery 60 days after transplantation was 83% (95% confidence interval [CI], 
      79%-87%) for the antibody-negative group (ab-negative), 73% (95% CI, 61%-82%) for 
      ab-positive, but only 32% (95% CI, 13%-53%) for the positive-vs-CB (P < .0001, 
      Gray test). With multivariate analysis, the ab-positive showed significantly 
      lower neutrophil recovery than the ab-negative (relative risk [RR] = 0.69, 95% 
      CI, 0.49-0.96, p = .027). The positive-vs-CB had significantly lower neutrophil 
      recovery (RR = 0.23, 95% CI, 0.09-0.56, P = .001) and platelet recovery (RR = 
      0.31, 95% CI, 0.12-0.81, P = .017) than the ab-negative. Patients' 
      pretransplantation anti-HLA antibodies should be tested and considered in the 
      selection of cord blood.
FAU - Takanashi, Minoko
AU  - Takanashi M
AD  - Japanese Red Cross Tokyo Blood Center, Tokyo, Japan. 
      mi-takanashi@tokyo.bc.jrc.or.jp
FAU - Atsuta, Yoshiko
AU  - Atsuta Y
FAU - Fujiwara, Koki
AU  - Fujiwara K
FAU - Kodo, Hideki
AU  - Kodo H
FAU - Kai, Shunro
AU  - Kai S
FAU - Sato, Hiroyuki
AU  - Sato H
FAU - Kohsaki, Masatoshi
AU  - Kohsaki M
FAU - Azuma, Hiroshi
AU  - Azuma H
FAU - Tanaka, Hidenori
AU  - Tanaka H
FAU - Ogawa, Atsuko
AU  - Ogawa A
FAU - Nakajima, Kazunori
AU  - Nakajima K
FAU - Kato, Shunichi
AU  - Kato S
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20100713
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 0 (Antigens, CD34)
RN  - 0 (HLA Antigens)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Antigens, CD34/metabolism
MH  - Child
MH  - Child, Preschool
MH  - *Cord Blood Stem Cell Transplantation/adverse effects
MH  - Female
MH  - Graft vs Host Disease/etiology/immunology
MH  - HLA Antigens/*immunology
MH  - Hematologic Neoplasms/blood/*immunology/mortality/*therapy
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Isoantibodies/*blood
MH  - Japan/epidemiology
MH  - Leukocyte Count
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Neutrophils
MH  - Recurrence
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2010/07/16 06:00
MHDA- 2010/11/06 06:00
CRDT- 2010/07/15 06:00
PHST- 2010/07/15 06:00 [entrez]
PHST- 2010/07/16 06:00 [pubmed]
PHST- 2010/11/06 06:00 [medline]
AID - S0006-4971(20)31273-8 [pii]
AID - 10.1182/blood-2009-10-249219 [doi]
PST - ppublish
SO  - Blood. 2010 Oct 14;116(15):2839-46. doi: 10.1182/blood-2009-10-249219. Epub 2010 
      Jul 13.