Impact of anti-HLA antibodies on allogeneic hematopoietic stem cell transplantation outcomes after reduced-intensity conditioning regimens

2012 ◽  
Vol 40 (10) ◽  
pp. 792-799 ◽  
Author(s):  
Marie Detrait ◽  
Valérie Dubois ◽  
Mohamad Sobh ◽  
Stéphane Morisset ◽  
Nathalie Tedone ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Reduced Intensity Conditioning ◽  
Hla Antibodies ◽  
Hematopoietic Stem ◽  
Conditioning Regimens ◽  
Transplantation Outcomes ◽  
Reduced Intensity

The Impact of Anti-HLA Antibodies on Allogeneic Hematopoietic Stem Cell Transplantation Outcomes After Reduced-Intensity Conditioning Regimens

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 2038-2038
Author(s):  
Marie Y. Detrait ◽  
Valerie Dubois ◽  
Mohamad Sobh ◽  
Stephane Morisset ◽  
Nathalie Tedone ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Univariate Analysis ◽  
Reduced Intensity Conditioning ◽  
Hla Antibodies ◽  
Hematopoietic Stem ◽  
Reduced Intensity

Abstract Abstract 2038 Introduction: Anti-HLA antibodies are associated with several complications in solid organ transplantations but their impact after allogeneic hematopoietic stem cell transplantation (HSCT) is not very well defined yet. Patients and methods: To evaluate the relevance of anti-HLA antibodies, we have retrospectively analyzed 107 peripheral blood allogeneic HSCT after reduced-intensity conditioning (RIC) regimen between 2005 and 2010. Acute myeloid leukaemia (n=52,48.5%) and multiple myeloma (n=18,17%) were the most common diagnosis in the cohort. The detection of anti-HLA antibodies was systematically performed in all patients before transplantation. Results: We found in 24 patients (22%) the presence of anti-HLA antibodies. There was no association between the presence of anti-HLA antibodies and engraftment, incidence of relapse or acute GvHD. The presence of anti-HLA antibodies was associated with worse survival in univariate analysis (HR 2.04; [95%CI,1.21–3.44], p=0.0056) and in multivariate analysis (HR 2.63; [95%CI, 1.32–5.25], p=0.006). The 3-year probability of OS was 34% (95%CI, 24–49) without anti-HLA antibodies and 16% (95%CI, 6–41) in their presence (Figure 1). The other significant factors on survival were the disease status at transplantation, the age, minor and major ABO incompatibilities between donor and recipient, the sex-mismatching and the CMV status. Moreover, the positive anti-HLA antibodies group showed a trend of higher TRM in univariate analysis (p=0.07) and in multivariate analysis (HR= 1.9; [95%CI, 0.94 – 3.9], p=0.076). The TRM at 3 years after transplantation were 31% (95%CI, 26–37) without anti-HLA antibodies and 46% (95%CI, 36–57) in their presence (figure 2). The causes of the pejorative effect of the anti-HLA antibodies were not defined yet but we observed microangiopathy associated with vascular endothelium damage which could be related to the presence of anti-HLA antibodies. Conclusion: Our study suggests that anti-HLA antibodies should be tested and considered as an important prognostic factor for transplant outcomes after RIC HSCT. Disclosures: No relevant conflicts of interest to declare.

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