Abstract
Aim Allogeneic haematopoietic stem cell transplantation is the treatment of choice for both pediatric and adult patients with onco-haematological diseases and non-malignant disorders. It is well known that an HLA-identical family donor is available in about 25% of cases and it is not always possible to promptly identify a voluntary donor in international registries. In the absence of a HLA-matched donor, the transplantation strategy is increasingly orienting towards the choice of allogeneic hematopoietic stem cell transplantation alternatives, such as the use of haploidentical family donors. The aim of this study was to determinate the presence in the recipients of donor specific anti-Human leukocyte antigen of class I and/or class II antibodies an correlate their potential role with the high rate of graft rejection observed. Methods The plasma or the sera of 23 patients affected by hemoglobinepathies, treated with a haploidentical transplant, were analyzed using the Mixed Antigen assay kit and subsequently, in case of positivity, with the Single Antigen beads assay kit (One Lambda, California) by Luminex technology. Results In the group of 23 transplanted patients affected by hemoglobinopathies, 9 rejected the graft. Among these, 3 (33.3%) showed the presence of DSA, while only 1 out of 14 patients with complete chimerism (7.1%) was positive for Donor-specific HLA Antibody. The presence of non-specific donor anti-Human leukocyte antigen antibodies class I and/or II was also demonstrated in 6 of the 23 patients analyzed, 3 of which were included in the group of 9 who rejected the transplantat (33.3%). Conclusions Our data showed that the presence of specific-donor anti-HLA antibodies represents a parameter associated with a higher percentage of rejection in haploidentical hematopoietic stem cell transplantation performed in patients affected by hemoglobinopathies, although a wider cohort of patients needs to be analyzed before drawing any conclusion. With the contribution of Berloni T. Galluccio: 1. Grant/Research Support; Company/Organization; IME Foundation. 2. Consultant; Company/Organization; Andreani Marco. 4. Scientific/Medical Advisor; Company/Organization; Andreani Marco. 5. Employee; Company/Organization; Galluccio Tiziana. A. Di Luzio: 1. Grant/Research Support; Company/Organization; IME Foundation. 2. Consultant; Company/Organization; Andreani Marco. 4. Scientific/Medical Advisor; Company/Organization; Andreani Marco. 5. Employee; Company/Organization; Di Luzio Andrea. M. Battarra: 1. Grant/Research Support; Company/Organization; Andreani Marco. 2. Consultant; Company/Organization; Andreani Marco. 4. Scientific/Medical Advisor; Company/Organization; Andreani Marco. 5. Employee; Company/Organization; Mariarosa Battarra.
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