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Yasumi M, Yokota T, Endo T, Kusakabe S, Koh Y, Sakamoto H, Inoue H, Sudo T, Hosen N, Karasuno T. Relationship between donor-specific HPA-15 antibodies and poor graft function in HPA-15 mismatched cord blood transplantation. Int J Hematol 2022; 115:753-758. [PMID: 35028883 DOI: 10.1007/s12185-022-03286-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 01/06/2022] [Accepted: 01/06/2022] [Indexed: 01/05/2023]
Abstract
Poor graft function (PGF) is a fatal complication following hematopoietic stem cell transplantation and is influenced by multiple factors, such as donor-specific anti-HLA antibodies, a poor infused CD34+ cell count, and the donor source. Alloantibodies against human platelet antigen 15 (HPA-15) recognize platelet membrane glycoprotein CD109, which is expressed not only on platelets, but also on megakaryocytes and specific hematopoietic stem cells. HPA-15 antibodies are known to induce platelet transfusion refractoriness and neonatal alloimmune thrombocytopenia, but their effects on graft function following hematopoietic stem cell transplantation remain unknown. We encountered a case of HPA-15 mismatched cord blood transplantation with a high HPA-15b antibody titer. Prolonged PGF and megakaryocyte aplasia with sustained high-titer HPA-15b antibodies were attenuated by rituximab therapy, and rapid recovery of hematopoiesis was achieved. HPA-15-compatible platelet transfusions were highly effective for platelet recovery. Methylcellulose assays and megakaryocyte cultures revealed that patient serum inhibited in vitro hematopoietic development from patient bone marrow cells. These results suggest that HPA-15 antibodies might be a cause of PGF and that reducing the HPA-15 antibody titer might improve graft function in HPA-15 mismatched transplantation.
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Affiliation(s)
- Masato Yasumi
- Department of Hematology, Rinku General Medical Center, 2-3 Ourai-Kita, Rinku, Izumisano, Osaka, 598-8577, Japan.
| | - Takafumi Yokota
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takaya Endo
- Department of Hematology, Rinku General Medical Center, 2-3 Ourai-Kita, Rinku, Izumisano, Osaka, 598-8577, Japan
| | - Shinsuke Kusakabe
- Department of Hematology, Rinku General Medical Center, 2-3 Ourai-Kita, Rinku, Izumisano, Osaka, 598-8577, Japan.,Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yangsook Koh
- Japanese Red Cross Kinki Block Blood Center, Ibaraki, Japan
| | - Hiroe Sakamoto
- Japanese Red Cross Kinki Block Blood Center, Ibaraki, Japan
| | - Hiroko Inoue
- Japanese Red Cross Kinki Block Blood Center, Ibaraki, Japan
| | - Takao Sudo
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Naoki Hosen
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takahiro Karasuno
- Department of Hematology, Rinku General Medical Center, 2-3 Ourai-Kita, Rinku, Izumisano, Osaka, 598-8577, Japan
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