The impact of anti-HLA antibodies on unrelated cord blood transplantations
The majority of cord blood transplantations (CBTs) have human leukocyte antigen (HLA) disparities. We investigated the impact that patients' pretransplantation anti-HLA antibodies have on the outcome of CBTs. Testing for anti-HLA antibody and its specificity was performed retrospectively at the...
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| Veröffentlicht in: | Blood 2010-10, Vol.116 (15), p.2839-2846 |
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| creator | Takanashi, Minoko Atsuta, Yoshiko Fujiwara, Koki Kodo, Hideki Kai, Shunro Sato, Hiroyuki Kohsaki, Masatoshi Azuma, Hiroshi Tanaka, Hidenori Ogawa, Atsuko Nakajima, Kazunori Kato, Shunichi |
| description | The majority of cord blood transplantations (CBTs) have human leukocyte antigen (HLA) disparities. We investigated the impact that patients' pretransplantation anti-HLA antibodies have on the outcome of CBTs. Testing for anti-HLA antibody and its specificity was performed retrospectively at the Japanese Red Cross Tokyo Blood Center with sensitive solid-phase antibody detection assays. Among 386 CBTs, which were first myeloablative stem cell transplantations for malignancies and used a single unit of cord blood, 89 tested positive. Among the antibody-positive group, the cord blood did not have the corresponding HLA type for the antibody in 69 cases (ab-positive), while 20 cases had specificity against the cord blood HLA (positive-vs-CB). Cumulative incidence of neutrophil recovery 60 days after transplantation was 83% (95% confidence interval [CI], 79%-87%) for the antibody-negative group (ab-negative), 73% (95% CI, 61%-82%) for ab-positive, but only 32% (95% CI, 13%-53%) for the positive-vs-CB (P < .0001, Gray test). With multivariate analysis, the ab-positive showed significantly lower neutrophil recovery than the ab-negative (relative risk [RR] = 0.69, 95% CI, 0.49-0.96, p = .027). The positive-vs-CB had significantly lower neutrophil recovery (RR = 0.23, 95% CI, 0.09-0.56, P = .001) and platelet recovery (RR = 0.31, 95% CI, 0.12-0.81, P = .017) than the ab-negative. Patients' pretransplantation anti-HLA antibodies should be tested and considered in the selection of cord blood. |
| doi_str_mv | 10.1182/blood-2009-10-249219 |
| format | Article |
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We investigated the impact that patients' pretransplantation anti-HLA antibodies have on the outcome of CBTs. Testing for anti-HLA antibody and its specificity was performed retrospectively at the Japanese Red Cross Tokyo Blood Center with sensitive solid-phase antibody detection assays. Among 386 CBTs, which were first myeloablative stem cell transplantations for malignancies and used a single unit of cord blood, 89 tested positive. Among the antibody-positive group, the cord blood did not have the corresponding HLA type for the antibody in 69 cases (ab-positive), while 20 cases had specificity against the cord blood HLA (positive-vs-CB). Cumulative incidence of neutrophil recovery 60 days after transplantation was 83% (95% confidence interval [CI], 79%-87%) for the antibody-negative group (ab-negative), 73% (95% CI, 61%-82%) for ab-positive, but only 32% (95% CI, 13%-53%) for the positive-vs-CB (P < .0001, Gray test). With multivariate analysis, the ab-positive showed significantly lower neutrophil recovery than the ab-negative (relative risk [RR] = 0.69, 95% CI, 0.49-0.96, p = .027). The positive-vs-CB had significantly lower neutrophil recovery (RR = 0.23, 95% CI, 0.09-0.56, P = .001) and platelet recovery (RR = 0.31, 95% CI, 0.12-0.81, P = .017) than the ab-negative. Patients' pretransplantation anti-HLA antibodies should be tested and considered in the selection of cord blood.</description><identifier>ISSN: 0006-4971</identifier><identifier>EISSN: 1528-0020</identifier><identifier>DOI: 10.1182/blood-2009-10-249219</identifier><identifier>PMID: 20628152</identifier><language>eng</language><publisher>Washington, DC: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Aged ; Antigens, CD34 - metabolism ; Biological and medical sciences ; Child ; Child, Preschool ; Cord Blood Stem Cell Transplantation - adverse effects ; Female ; Graft vs Host Disease - etiology ; Graft vs Host Disease - immunology ; Hematologic and hematopoietic diseases ; Hematologic Neoplasms - blood ; Hematologic Neoplasms - immunology ; Hematologic Neoplasms - mortality ; Hematologic Neoplasms - therapy ; HLA Antigens - immunology ; Humans ; Infant ; Infant, Newborn ; Isoantibodies - blood ; Japan - epidemiology ; Leukocyte Count ; Male ; Medical sciences ; Middle Aged ; Multivariate Analysis ; Neutrophils ; Recurrence ; Retrospective Studies ; Risk Factors ; Treatment Outcome ; Young Adult</subject><ispartof>Blood, 2010-10, Vol.116 (15), p.2839-2846</ispartof><rights>2010 American Society of Hematology</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c554t-95bd54eb108df7a4678f6d6af707bf7539061dd9cf2dfe65db1d1f63b4df5ca63</citedby><cites>FETCH-LOGICAL-c554t-95bd54eb108df7a4678f6d6af707bf7539061dd9cf2dfe65db1d1f63b4df5ca63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23324699$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20628152$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Takanashi, Minoko</creatorcontrib><creatorcontrib>Atsuta, Yoshiko</creatorcontrib><creatorcontrib>Fujiwara, Koki</creatorcontrib><creatorcontrib>Kodo, Hideki</creatorcontrib><creatorcontrib>Kai, Shunro</creatorcontrib><creatorcontrib>Sato, Hiroyuki</creatorcontrib><creatorcontrib>Kohsaki, Masatoshi</creatorcontrib><creatorcontrib>Azuma, Hiroshi</creatorcontrib><creatorcontrib>Tanaka, Hidenori</creatorcontrib><creatorcontrib>Ogawa, Atsuko</creatorcontrib><creatorcontrib>Nakajima, Kazunori</creatorcontrib><creatorcontrib>Kato, Shunichi</creatorcontrib><title>The impact of anti-HLA antibodies on unrelated cord blood transplantations</title><title>Blood</title><addtitle>Blood</addtitle><description>The majority of cord blood transplantations (CBTs) have human leukocyte antigen (HLA) disparities. We investigated the impact that patients' pretransplantation anti-HLA antibodies have on the outcome of CBTs. Testing for anti-HLA antibody and its specificity was performed retrospectively at the Japanese Red Cross Tokyo Blood Center with sensitive solid-phase antibody detection assays. Among 386 CBTs, which were first myeloablative stem cell transplantations for malignancies and used a single unit of cord blood, 89 tested positive. Among the antibody-positive group, the cord blood did not have the corresponding HLA type for the antibody in 69 cases (ab-positive), while 20 cases had specificity against the cord blood HLA (positive-vs-CB). Cumulative incidence of neutrophil recovery 60 days after transplantation was 83% (95% confidence interval [CI], 79%-87%) for the antibody-negative group (ab-negative), 73% (95% CI, 61%-82%) for ab-positive, but only 32% (95% CI, 13%-53%) for the positive-vs-CB (P < .0001, Gray test). With multivariate analysis, the ab-positive showed significantly lower neutrophil recovery than the ab-negative (relative risk [RR] = 0.69, 95% CI, 0.49-0.96, p = .027). The positive-vs-CB had significantly lower neutrophil recovery (RR = 0.23, 95% CI, 0.09-0.56, P = .001) and platelet recovery (RR = 0.31, 95% CI, 0.12-0.81, P = .017) than the ab-negative. Patients' pretransplantation anti-HLA antibodies should be tested and considered in the selection of cord blood.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Antigens, CD34 - metabolism</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cord Blood Stem Cell Transplantation - adverse effects</subject><subject>Female</subject><subject>Graft vs Host Disease - etiology</subject><subject>Graft vs Host Disease - immunology</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Hematologic Neoplasms - blood</subject><subject>Hematologic Neoplasms - immunology</subject><subject>Hematologic Neoplasms - mortality</subject><subject>Hematologic Neoplasms - therapy</subject><subject>HLA Antigens - immunology</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Isoantibodies - blood</subject><subject>Japan - epidemiology</subject><subject>Leukocyte Count</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Neutrophils</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0006-4971</issn><issn>1528-0020</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtLxDAQgIMouj7-gUgv4ik6SZO0vQiy-GTBi55Dmkww0m3WpCv47-0-1JunGYZvXh8hpwwuGav5VdvF6CgHaCgDykXDWbNDJkzymgJw2CUTAFBUNBU7IIc5vwMwUXK5Tw44KF6P5IQ8vbxhEeYLY4ci-sL0Q6APs5t10kYXMBexL5Z9ws4M6AobkyvWq4shmT4vupE0Q4h9PiZ73nQZT7bxiLze3b5MH-js-f5xejOjVkox0Ea2TgpsGdTOV0aoqvbKKeMrqFpfybIBxZxrrOfOo5KuZY55VbbCeWmNKo_IxWbuIsWPJeZBz0O22I2XYFxmXcm6Lqsa-EiKDWlTzDmh14sU5iZ9aQZ6JVGvP9EriavSRuLYdrZdsGzn6H6bfqyNwPkWMNmazo8ibMh_XFlyoZrVoOsNh6OOz4BJZxuwt-hCQjtoF8P_l3wDIHiQsw</recordid><startdate>20101014</startdate><enddate>20101014</enddate><creator>Takanashi, Minoko</creator><creator>Atsuta, Yoshiko</creator><creator>Fujiwara, Koki</creator><creator>Kodo, Hideki</creator><creator>Kai, Shunro</creator><creator>Sato, Hiroyuki</creator><creator>Kohsaki, Masatoshi</creator><creator>Azuma, Hiroshi</creator><creator>Tanaka, Hidenori</creator><creator>Ogawa, Atsuko</creator><creator>Nakajima, Kazunori</creator><creator>Kato, Shunichi</creator><general>Elsevier Inc</general><general>Americain Society of Hematology</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20101014</creationdate><title>The impact of anti-HLA antibodies on unrelated cord blood transplantations</title><author>Takanashi, Minoko ; Atsuta, Yoshiko ; Fujiwara, Koki ; Kodo, Hideki ; Kai, Shunro ; Sato, Hiroyuki ; Kohsaki, Masatoshi ; Azuma, Hiroshi ; Tanaka, Hidenori ; Ogawa, Atsuko ; Nakajima, Kazunori ; Kato, Shunichi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c554t-95bd54eb108df7a4678f6d6af707bf7539061dd9cf2dfe65db1d1f63b4df5ca63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Antigens, CD34 - metabolism</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cord Blood Stem Cell Transplantation - adverse effects</topic><topic>Female</topic><topic>Graft vs Host Disease - etiology</topic><topic>Graft vs Host Disease - immunology</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Hematologic Neoplasms - blood</topic><topic>Hematologic Neoplasms - immunology</topic><topic>Hematologic Neoplasms - mortality</topic><topic>Hematologic Neoplasms - therapy</topic><topic>HLA Antigens - immunology</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Isoantibodies - blood</topic><topic>Japan - epidemiology</topic><topic>Leukocyte Count</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Neutrophils</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Takanashi, Minoko</creatorcontrib><creatorcontrib>Atsuta, Yoshiko</creatorcontrib><creatorcontrib>Fujiwara, Koki</creatorcontrib><creatorcontrib>Kodo, Hideki</creatorcontrib><creatorcontrib>Kai, Shunro</creatorcontrib><creatorcontrib>Sato, Hiroyuki</creatorcontrib><creatorcontrib>Kohsaki, Masatoshi</creatorcontrib><creatorcontrib>Azuma, Hiroshi</creatorcontrib><creatorcontrib>Tanaka, Hidenori</creatorcontrib><creatorcontrib>Ogawa, Atsuko</creatorcontrib><creatorcontrib>Nakajima, Kazunori</creatorcontrib><creatorcontrib>Kato, Shunichi</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Blood</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Takanashi, Minoko</au><au>Atsuta, Yoshiko</au><au>Fujiwara, Koki</au><au>Kodo, Hideki</au><au>Kai, Shunro</au><au>Sato, Hiroyuki</au><au>Kohsaki, Masatoshi</au><au>Azuma, Hiroshi</au><au>Tanaka, Hidenori</au><au>Ogawa, Atsuko</au><au>Nakajima, Kazunori</au><au>Kato, Shunichi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of anti-HLA antibodies on unrelated cord blood transplantations</atitle><jtitle>Blood</jtitle><addtitle>Blood</addtitle><date>2010-10-14</date><risdate>2010</risdate><volume>116</volume><issue>15</issue><spage>2839</spage><epage>2846</epage><pages>2839-2846</pages><issn>0006-4971</issn><eissn>1528-0020</eissn><abstract>The majority of cord blood transplantations (CBTs) have human leukocyte antigen (HLA) disparities. We investigated the impact that patients' pretransplantation anti-HLA antibodies have on the outcome of CBTs. Testing for anti-HLA antibody and its specificity was performed retrospectively at the Japanese Red Cross Tokyo Blood Center with sensitive solid-phase antibody detection assays. Among 386 CBTs, which were first myeloablative stem cell transplantations for malignancies and used a single unit of cord blood, 89 tested positive. Among the antibody-positive group, the cord blood did not have the corresponding HLA type for the antibody in 69 cases (ab-positive), while 20 cases had specificity against the cord blood HLA (positive-vs-CB). Cumulative incidence of neutrophil recovery 60 days after transplantation was 83% (95% confidence interval [CI], 79%-87%) for the antibody-negative group (ab-negative), 73% (95% CI, 61%-82%) for ab-positive, but only 32% (95% CI, 13%-53%) for the positive-vs-CB (P < .0001, Gray test). With multivariate analysis, the ab-positive showed significantly lower neutrophil recovery than the ab-negative (relative risk [RR] = 0.69, 95% CI, 0.49-0.96, p = .027). The positive-vs-CB had significantly lower neutrophil recovery (RR = 0.23, 95% CI, 0.09-0.56, P = .001) and platelet recovery (RR = 0.31, 95% CI, 0.12-0.81, P = .017) than the ab-negative. Patients' pretransplantation anti-HLA antibodies should be tested and considered in the selection of cord blood.</abstract><cop>Washington, DC</cop><pub>Elsevier Inc</pub><pmid>20628152</pmid><doi>10.1182/blood-2009-10-249219</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Antigens, CD34 - metabolism Biological and medical sciences Child Child, Preschool Cord Blood Stem Cell Transplantation - adverse effects Female Graft vs Host Disease - etiology Graft vs Host Disease - immunology Hematologic and hematopoietic diseases Hematologic Neoplasms - blood Hematologic Neoplasms - immunology Hematologic Neoplasms - mortality Hematologic Neoplasms - therapy HLA Antigens - immunology Humans Infant Infant, Newborn Isoantibodies - blood Japan - epidemiology Leukocyte Count Male Medical sciences Middle Aged Multivariate Analysis Neutrophils Recurrence Retrospective Studies Risk Factors Treatment Outcome Young Adult |
| title | The impact of anti-HLA antibodies on unrelated cord blood transplantations |
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