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

IF 0.7 4区 医学 Q4 HEMATOLOGY Indian Journal of Hematology and Blood Transfusion Pub Date : 2024-04-01 Epub Date: 2023-06-20 DOI:10.1007/s12288-023-01661-2
Vimal Kumar, Rishab Bharadwaj, Deepti Sachan, Deenadayalan Munirathnam
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Abstract

To assess the incidence of anti-HLA donor-specific antibodies and the effectiveness of desensitization strategy in children who underwent haploidentical HSCT at our hospital. A retrospective review, management and outcomes of children with positive anti-HLA DSA who underwent haploidentical HSCT at our hospital from 2020 to 2022. Three patients with Thalassemia major were treated with 2 cycles of pretransplant immune suppression (PTIS) comprising Fludarabine and Dexamethasone in addition to desensitization. Five out of the 26 children who underwent haploidentical HSCT had positive anti-HLA DSA. Post desensitization, three out of the 5 children engrafted with sustained full donor chimerism, 1 patient developed primary graft rejection, while 1 patient died. It is feasible to desensitize children with high anti-HLA donor specific antibodies undergoing haploidentical HSCT to improve outcomes.

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高抗HLA供体特异性抗体儿童单核造血干细胞移植有效减敏策略的单中心经验
评估在我院接受单倍体造血干细胞移植的儿童中抗HLA供体特异性抗体的发生率和脱敏策略的有效性。回顾性分析 2020 年至 2022 年期间在我院接受单倍体造血干细胞移植的抗-HLA DSA 阳性患儿的管理和疗效。三名重型地中海贫血患者接受了两个周期的移植前免疫抑制(PTIS)治疗,包括氟达拉滨和地塞米松以及脱敏治疗。在接受单倍体造血干细胞移植的 26 名患儿中,有 5 名患儿的抗 HLA DSA 呈阳性。脱敏后,5名儿童中有3名获得了持续的完全供体嵌合,1名患者出现了原发性移植物排斥反应,1名患者死亡。对接受单倍体造血干细胞移植的高抗HLA供体特异性抗体患儿进行脱敏治疗以改善预后是可行的。
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来源期刊
CiteScore
1.70
自引率
0.00%
发文量
82
审稿时长
>12 weeks
期刊介绍: Indian Journal of Hematology and Blood Transfusion is a medium for propagating and exchanging ideas within the medical community. It publishes peer-reviewed articles on a variety of aspects of clinical hematology, laboratory hematology and hemato-oncology. The journal exists to encourage scientific investigation in the study of blood in health and in disease; to promote and foster the exchange and diffusion of knowledge relating to blood and blood-forming tissues; and to provide a forum for discussion of hematological subjects on a national scale. The Journal is the official publication of The Indian Society of Hematology & Blood Transfusion.
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