Kumar Vimal, Bharadwaj Rishab, Sachan Deepti, Munirathnam Deenadayalan
Department of Pediatric Hematology, Oncology and Blood & Marrow Transplantation, Dr Rela Institute and Medical Centre, 7, CLC Works Road, Chromepet, Chennai, India.
Department of Transfusion Medicine, Dr Rela Institute and Medical Centre, Chennai, India.
Indian J Hematol Blood Transfus. 2024 Apr;40(2):335-339. doi: 10.1007/s12288-023-01661-2. Epub 2023 Jun 20.
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.
评估我院接受单倍体造血干细胞移植（haploidentical HSCT）儿童中抗人白细胞抗原（HLA）供者特异性抗体的发生率以及脱敏策略的有效性。对2020年至2022年在我院接受单倍体HSCT且抗HLA供者特异性抗体（DSA）呈阳性的儿童进行回顾性分析、管理及观察其结局。3例重型地中海贫血患儿除进行脱敏治疗外，还接受了2个周期包含氟达拉滨和地塞米松的移植前免疫抑制（PTIS）治疗。在26例接受单倍体HSCT的儿童中，5例抗HLA DSA呈阳性。脱敏治疗后，5例儿童中有3例植入并维持完全供者嵌合状态，1例发生原发性移植物排斥反应，1例死亡。对接受单倍体HSCT且抗HLA供者特异性抗体水平高的儿童进行脱敏治疗以改善结局是可行的。
