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Durand G, Desoutter J, Lorriaux C, Poumaredes G, Joris M, Charbonnier A, Lebon D, Paubelle E, Garcon L, Guillaume N. Platelet transfusions in haploidentical haematopoietic stem cell allograft candidates: Protecting HLA-A and HLA-B antigens through eplet analysis. HLA 2024; 103:e15438. [PMID: 38516935 DOI: 10.1111/tan.15438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 01/29/2024] [Accepted: 02/28/2024] [Indexed: 03/23/2024]
Abstract
In patients awaiting an allogeneic haematopoietic stem cell transplantation, platelet transfusion is a risk factor for anti-HLA class I immunization because the resulting donor-specific antibodies complicate the allograft process. The objective of the present study was to determine the feasibility of a novel eplet-based strategy for identifying HLA class I mismatches between potential donors and the recipient when pre-allograft platelet transfusions were required. We included 114 recipient/haploidentical relative pairs. For each pair, we entered HLA-class I typing data into the HLA Eplet Mismatch calculator, defined the list of mismatched eplets (for the recipient versus donor direction) and thus identified the shared HLAs to be avoided. Using this list of HLAs, we defined the theoretical availability of platelet components (PCs) by calculating the virtual panel-reactive antibody (vPRA). We also determined the number of PCs actually available in France by querying the regional transfusion centre's database. The mean ± standard deviation number of highly/moderately exposed eplets to be avoided in platelet transfusions was 5.8 ± 3.3, which led to the prohibition of 38.5 ± 2 HLAs-A and -B. Taking into account the mismatched antigens and the eplet load, the mean ± standard deviation theoretical availability of PCs (according to the vPRA) was respectively 34.49% ± 1.95% for HLA-A and 80% ± 2.3% for HLA-B. A vPRA value below 94.9% for highly or moderately exposed eplets would predict that 10 PCs were actually available nationally. Although epitope protection of HLA molecules is feasible, it significantly restricts the choice of PCs.
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Affiliation(s)
- Gatien Durand
- Department of Haematology and Histocompatibility, Amiens University Hospital, Amiens, France
- EA HEMATIM 4666, Jules Verne University of Picardie, Amiens, France
| | - Judith Desoutter
- Department of Haematology and Histocompatibility, Amiens University Hospital, Amiens, France
- EA HEMATIM 4666, Jules Verne University of Picardie, Amiens, France
| | - Corinne Lorriaux
- Department of Blood Transfusions, Amiens University Hospital, Amiens, France
| | - Géraldine Poumaredes
- Department of Biology, Etablissement Français du Sang (EFS) Hauts de France, Amiens, France
| | - Magalie Joris
- Department of Clinical Haematology and Cellular Therapy, Amiens University Hospital, Amiens, France
| | - Amandine Charbonnier
- Department of Clinical Haematology and Cellular Therapy, Amiens University Hospital, Amiens, France
| | - Delphine Lebon
- EA HEMATIM 4666, Jules Verne University of Picardie, Amiens, France
- Department of Clinical Haematology and Cellular Therapy, Amiens University Hospital, Amiens, France
| | - Etienne Paubelle
- EA HEMATIM 4666, Jules Verne University of Picardie, Amiens, France
- Department of Clinical Haematology and Cellular Therapy, Amiens University Hospital, Amiens, France
| | - Loïc Garcon
- Department of Haematology and Histocompatibility, Amiens University Hospital, Amiens, France
- EA HEMATIM 4666, Jules Verne University of Picardie, Amiens, France
| | - Nicolas Guillaume
- Department of Haematology and Histocompatibility, Amiens University Hospital, Amiens, France
- EA HEMATIM 4666, Jules Verne University of Picardie, Amiens, France
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Soudet S, Jedraszak G, Evrard O, Marolleau JP, Garcon L, Pietri MAS. Is Hematopoietic Clonality of Indetermined Potential a Risk Factor for Pulmonary Embolism? TH Open 2021; 5:e338-e342. [PMID: 34414354 PMCID: PMC8370792 DOI: 10.1055/s-0041-1733856] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 07/01/2021] [Indexed: 12/15/2022] Open
Abstract
Background
Unprovoked pulmonary embolism (uPE) is a severe and frequent condition. Identification of new risk factors is mandatory to identify patients that would benefit from a long-term treatment. Clonal hematopoiesis of indeterminate potential (CHIP) is defined by the acquisition of somatic mutations that drive clonal expansion in the absence of cytopenia. Its prevalence is estimated of 5% in the population above 65 years. Since inflammation and endothelial dysfunction may share a pathophysiological pathway(1), we hypothesized that CHIP, may be a risk factor for uPE.
Methods
We conducted a pilot retrospective observational study. Patients with iPE between 18 to 65 years old were included. PE was considered as unprovoked, when no transient nor persistant risk factor was present and when thrombophilia testing was negative. We excluded documented atherosclerosis, personal or familial history of VTE and presence of cytopenias. CHIP proportion in uPE patients were analyzed using next generation sequencing of the coding sequence of a custom panel composed by
DNMT3A, ASXL1, SF3B1, TET2
and
TP 53
.
Results
Upon 61 patients with uPE consecutively included, a total of 19 somatic mutations were found in 12 patients (20%) IC95% [10 - 20]. 15 mutations were found in
DNMT3A
gene, 3 in
ASXL1
and one in
TET2
. There was no diference in terms of age, PE location, DVT presence and risk stratification in CHIP carriers and non carriers.
Conclusion
We report for the first time, the presence of high rates of CHIP in patients presenting with uPE. Thus, CHIP may be a new risk factor for VTE. These results need to be confirmed in an ongoing prospective case-control study including more patients and using a more diverse gene panel to better determine CHIP incidence in uPE.
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Affiliation(s)
- S Soudet
- Department of Vascular Medicine, CHU Amiens Picardie, Amiens, France.,EA 7516 CHIMERE, Université Picardie Jules Verne, Amiens, France
| | - G Jedraszak
- Department of Genetic, CHU Amiens Picardie, Amiens, France.,EA 4666 HEMATIM, Université Picardie Jules Verne, Amiens, France
| | - O Evrard
- Department of Genetic, CHU Amiens Picardie, Amiens, France.,EA 4666 HEMATIM, Université Picardie Jules Verne, Amiens, France
| | - J P Marolleau
- Department of Genetic, CHU Amiens Picardie, Amiens, France.,EA 4666 HEMATIM, Université Picardie Jules Verne, Amiens, France
| | - L Garcon
- Department of Genetic, CHU Amiens Picardie, Amiens, France.,EA 4666 HEMATIM, Université Picardie Jules Verne, Amiens, France
| | - M A Sevestre Pietri
- Department of Vascular Medicine, CHU Amiens Picardie, Amiens, France.,EA 7516 CHIMERE, Université Picardie Jules Verne, Amiens, France
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Nagasaki Y, Yoshitomi T, Hirayama A, Schock-Kusch D, Xie Q, Shulhevich Y, Hesser J, Stsepankou S, Koenig S, Heinrich R, Pill J, Gretz N, Efrati S, Berman S, Abu-Hamad R, Siman-Tov Y, Weissgarten J, Kimura T, Takabatake Y, Takahashi A, Kaimori JY, Matsui I, Namba T, Kitamura H, Niimura F, Matsusaka T, Rakugi H, Isaka Y, Ito K, Watanabe M, Nakashima H, Abe Y, Ifuku M, Nishimura S, Saito T, Mulay SR, Thomasova D, Ryu M, Anders HJ, Nakayama Y, Ueda S, Yamagishi SI, Ando R, Kaida Y, Iwatani R, Fujimi A, Fukami K, Okuda S, Shin YT, Jeong JY, Jang WI, Chung S, Choi DE, Na KR, Lee KW, Mugitani N, Shimizu Y, Satake K, Suzuki Y, Horikoshi S, Tomino Y, Schneider R, Meusel M, Betz B, Wanner C, Koepsell H, Sauvant C, Dursun B, Abban G, Kucukatay V, Tufan L, Dodurga Y, Guclu A, Gok D, Vicente-Vicente L, Sanchez-Gonzalez PD, Prieto M, Lopez-Novoa JM, Lopez-Hernandez FJ, Morales AI, Torres A, Dnyanmote A, Wu W, Nigam S, Wystrychowski A, Wystrychowski W, Kolodziejczyk A, Obuchowicz E, Wiecek A, Sanchez-Gonzalez PD, Vicente-Vicente L, Prieto M, Lopez-Hernandez FJ, Lopez-Novoa JM, Morales AI, Reis LA, Borges FT, Simoes MDJ, Schor N, Mesnard L, Rafat C, Vandermeersch S, Nochy D, Garcon L, Callard P, Jouanneau C, Verpont MC, Hertig A, Rondeau E, Grosjean F, Torreggiani M, Esposito V, Mangione F, Serpieri N, Villa L, Sileno G, Marchi G, Fasoli G, Esposito C, Dal Canton A, Sancho-Martinez S, Lopez-Novoa JM, Lopez-Hernandez FJ, Esposito V, Grosjean F, Striker G, Vlassara H, Zheng F, Park DJ, Kim JH, Jung MH, Seo JW, Kim HJ, Chang SH, Han BG, Yang JW, Yu JM, Choi SO, Efrati S, Berman S, Abu-Hamad R, Siman-Tov Y, Weissgarten J, Reis LA, Christo JS, Simoes MDJ, Schor N, Rusai K, Prokai A, Szebeni B, Meszaros K, Fekete A, Treszl A, Vannay A, Muller V, Reusz G, Heemann U, Tulassay T, Lutz J, Szabo AJ, Ranghino A, Bruno S, Grange C, Dolla C, Cantaluppi V, Biancone L, Tetta C, Segoloni GP, Camussi G, Pinto V, Teixeira V, Almeida W, Schor N, Reis LA, Borges FT, Simoes MDJ, Schor N, Fujikura T, Sun Y, Iwakura T, Yasuda H, Fujigaki Y, Simone S, Rascio F, Loverre A, Cosola C, Cariello M, Castellano G, Ditonno P, Schena FP, Gesualdo L, Grandaliano G, Pertosa G, Choi JY, Kim J, Jin DC, Cha JH, Vicente-Vicente L, Prieto M, Sanchez-Gonzalez PD, Lopez-Novoa JM, Lopez-Hernandez FJ, Morales AI, Kaynar K, Aliyazicioglu R, Ersoz S, Ulusoy S, Al S, Ozkan G, Cansiz M, Fuchs TC, Emde B, Czasch S, von Landenberg F, Hewitt P, Abu-Salah N, Bishara B, Awad H, Ghrayeb N, Assady S, Armaly Z, Better O, Abassi Z. Acute kidney injury - Experimental models. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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