Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr 1;44(3):e689-e694.
doi: 10.1097/MPH.0000000000002357.

The Impact of Panel Reactive Antibodies and Different Desensitization Methods on Pediatric Allogeneic Hematopoietic Stem Cell Transplantation Outcomes

Burcu Akinci  1 , Arzu Akçay, Fatma Demir Yenigürbüz, Didem Atay, Gülyüz Öztürk
Affiliations

The Impact of Panel Reactive Antibodies and Different Desensitization Methods on Pediatric Allogeneic Hematopoietic Stem Cell Transplantation Outcomes

Burcu Akinci et al. J Pediatr Hematol Oncol. .

Abstract

Introduction: In highly sensitized patients who have panel reactive antibodies (PRAs) before hematopoietic stem cell transplantation, primary graft failure risk may increase. In this study, we aimed to determine the association of PRA with engraftment, and graft versus host disease (GVHD) in pediatric patients.

Materials and methods: Forty-three PRA-positive and 42 PRA-negative patients were taken into study. Both groups were compared in terms of graft failure, acute GVHD, viral infection and survival rates. PRA-positive group was also divided into 2 according to treatment modality (steroid-only group/combination therapy) and compared for the same parameters.

Results: There was no difference in PRA-positive and negative patients in terms of graft failure, acute GVHD and viral infections. Analysis of the PRA-positive group in itself showed that there was also no difference in terms of graft failure and viral infection frequency. The only difference is that acute grade 3 to 4 GVHD was higher in the steroid-only group. The 100-day overall survival was 90.2% and 90.4% for the PRA-positive and negative groups, respectively.

Conclusions: Different treatment strategies like plasmapheresis, steroid, rituximab, or combination therapies can be used for the desensitization of PRA-positive patients before hematopoietic stem cell transplantation. Patient-specific treatment modality for sensitized patients before transplant can increase the success rate.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

References

    1. Akgul SU, Ciftci HS, Temurhan S, et al. Association between HLA antibodies and different sensitization events in renal transplant candidates. Transplant Proc. 2017;49:425–429.
    1. Hung SY, Lin TM, Chang MY, et al. Risk factors of sensitization to human leukocyte antigen in end-stage renal disease patients. Hum Immonul. 2014;75:531–535.
    1. Takanashi M, Atsuta Y, Fujiwara K, et al. The impact of anti-HLA antibodies on unrelated cord blood transplantations. Blood. 2010;116:2839–2846.
    1. Detrait M, Dubois V, Sobh M, et al. Impact of anti-HLA antibodies on allogeneic hematopoietic stem cell transplantation outcomes after reduced-intensity conditioning regimens. Exp Hematol. 2012;40:792–799.
    1. Rocca UL, Perrone MP, Piciocchi A, et al. Anti-HLA donor-specific antibodies in allogeneic stem cell transplantation: management and desensitization protocol. Bone Marrow Transplant. 2019;54:1717–1720.