King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Elm University College of Pharmacy, Riyadh, Saudi Arabia.
Bone Marrow Transplant. 2023 Jun;58(6):680-686. doi: 10.1038/s41409-023-01950-4. Epub 2023 Mar 23.
PGF is a devastating complication after allogeneic transplant. We retrospectively analyzed our haploidentical transplant registry to report the incidence and impact of DSA and anti-HLA on engraftment. 107 patients were identified. Median recipient-age of 22, median donor-age of 31. Sixty-two patients had AML (58%), 29 had ALL (27%), 16 (15%) had other malignancies. Sixty-one recipients (57%) had positive anti-HLA, 56 of them had the DSA results available, of these 17 patients had DSAs (15% of the total number of patients, or 28% of patients who have anti-HLA antibodies). The median cumulative MFI was 2062. Sixty-three percent of the DSA were against class-II HLA antigens. The OS, CIR, aGvHD, and cGvHD did not differ between patients with and without anti-HLA antibodies, nor between patients with and without DSA. The gender of the recipient and donor, as well as the gender mismatch between recipient and donor, were statistically associated with the incidence of anti-HLA antibodies. Three patients only developed GF (2.8%), one was primary (0.9%) and the other two secondary GF (1.9%). None of the GF cases was in patients with anti-HLA antibodies or DSA. The presence of anti-HLA or DSAs did not affect the outcomes including the incidence of PGF.
PGF 是异基因移植后的一种毁灭性并发症。我们回顾性分析了我们的单倍体移植登记处，以报告 DSA 和抗 HLA 对植入的发生率和影响。确定了 107 名患者。中位受体年龄为 22 岁，中位供体年龄为 31 岁。62 名患者患有 AML（58%），29 名患有 ALL（27%），16 名（15%）患有其他恶性肿瘤。61 名受体（57%）具有阳性抗 HLA，其中 56 名具有 DSA 结果，其中 17 名患者具有 DSA（总患者数的 15%，或具有抗 HLA 抗体的患者的 28%）。中位累积 MFI 为 2062。63%的 DSA 针对 II 类 HLA 抗原。OS、CIR、aGvHD 和 cGvHD 在具有和不具有抗 HLA 抗体的患者之间以及在具有和不具有 DSA 的患者之间没有差异。受体和供体的性别以及受体和供体之间的性别不匹配与抗 HLA 抗体的发生率具有统计学关联。只有 3 名患者仅发展为 GF（2.8%），1 名是原发性（0.9%），另外 2 名是继发性 GF（1.9%）。GF 病例均不在具有抗 HLA 抗体或 DSA 的患者中。抗 HLA 或 DSA 的存在不影响包括 PGF 发生率在内的结果。
