PMID- 36129238
OWN - NLM
STAT- MEDLINE
DCOM- 20221031
LR  - 20221206
IS  - 1545-5017 (Electronic)
IS  - 1545-5009 (Linking)
VI  - 69
IP  - 12
DP  - 2022 Dec
TI  - Outcomes of patients who underwent treatment for anti-HLA donor-specific 
      antibodies before receiving a haploidentical hematopoietic cell transplant.
PG  - e29993
LID - 10.1002/pbc.29993 [doi]
AB  - Pediatric and adolescent and young adult (AYA) patients who receive many blood 
      product transfusions, such as individuals with sickle cell disease (SCD), severe 
      aplastic anemia (SAA) or indolent hematologic malignancies, are at high risk for 
      developing donor-specific antibodies (DSA). DSAs with mean fluorescence intensity 
      (MFI) greater than 5000 have been associated with significant graft failure, but 
      lower MFI values between 2000 and 5000 may result in poor graft function after 
      hematopoietic cell transplant (HCT). Desensitization strategies have been 
      developed to reduce the DSA burden in HCT recipients before graft infusion, but 
      the experience with these strategies in the pediatric and AYA populations is not 
      well described in the literature. Here, we describe our experience with 
      successful desensitization by using a combination of treatment strategies in five 
      pediatric and AYA patients, including a novel use of daratumumab in a young adult 
      patient who had refractory DSAs and had suffered serious side effects from 
      conventional desensitization strategies. The presence of elevated DSAs in 
      pediatric and AYA recipients of a human leukocyte antigen (HLA)-mismatched 
      haploidentical HCT can be overcome by a multipronged treatment strategy.
CI  - (c) 2022 Wiley Periodicals LLC.
FAU - Lipsitt, Amanda
AU  - Lipsitt A
AD  - Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude 
      Children's Research Hospital, Memphis, Tennessee, USA.
FAU - Arnold, Paula
AU  - Arnold P
AUID- ORCID: 0000-0002-9493-7982
AD  - Department of Pathology, St. Jude Children's Research Hospital, Memphis, 
      Tennessee, USA.
FAU - Chi, Liying
AU  - Chi L
AD  - Department of Pathology, St. Jude Children's Research Hospital, Memphis, 
      Tennessee, USA.
FAU - Carruthers, Katharine
AU  - Carruthers K
AD  - Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude 
      Children's Research Hospital, Memphis, Tennessee, USA.
FAU - Folk, Sophia
AU  - Folk S
AD  - Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude 
      Children's Research Hospital, Memphis, Tennessee, USA.
FAU - Fossey, Sallyanne
AU  - Fossey S
AD  - Transplant Immunology Laboratory, Dialysis Clinic Inc, Nashville, Tennessee, USA.
FAU - Keerthi, Dinesh
AU  - Keerthi D
AD  - Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude 
      Children's Research Hospital, Memphis, Tennessee, USA.
FAU - Mamcarz, Ewelina
AU  - Mamcarz E
AD  - Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude 
      Children's Research Hospital, Memphis, Tennessee, USA.
FAU - Srinivasan, Ashok
AU  - Srinivasan A
AD  - Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude 
      Children's Research Hospital, Memphis, Tennessee, USA.
FAU - Sharma, Akshay
AU  - Sharma A
AUID- ORCID: 0000-0003-3281-2081
AD  - Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude 
      Children's Research Hospital, Memphis, Tennessee, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220921
PL  - United States
TA  - Pediatr Blood Cancer
JT  - Pediatric blood & cancer
JID - 101186624
RN  - 0 (HLA Antigens)
RN  - 0 (Antibodies)
SB  - IM
MH  - Young Adult
MH  - Adolescent
MH  - Humans
MH  - Child
MH  - *Hematopoietic Stem Cell Transplantation
MH  - Graft Survival
MH  - HLA Antigens
MH  - Tissue Donors
MH  - Transplantation Conditioning
MH  - Antibodies
MH  - Graft Rejection
OTO - NOTNLM
OT  - desensitization
OT  - donor-specific antibodies
OT  - hematopoietic cell transplant
EDAT- 2022/09/22 06:00
MHDA- 2022/11/01 06:00
CRDT- 2022/09/21 08:33
PHST- 2022/08/08 00:00 [revised]
PHST- 2022/07/05 00:00 [received]
PHST- 2022/08/22 00:00 [accepted]
PHST- 2022/09/22 06:00 [pubmed]
PHST- 2022/11/01 06:00 [medline]
PHST- 2022/09/21 08:33 [entrez]
AID - 10.1002/pbc.29993 [doi]
PST - ppublish
SO  - Pediatr Blood Cancer. 2022 Dec;69(12):e29993. doi: 10.1002/pbc.29993. Epub 2022 
      Sep 21.