Impact of Donor-Specific anti-HLA antibodies and donor KIR characteristics in haploidentical HSCT for beta-Thalassemia

Main Article Content

Marco Andreani
Manuela Testi
Pietro Sodani
Maria Troiano
Andrea Di Luzio
Giuseppe Testa
Michela Falco
Elvira Poggi
Javid Gaziev
Antonina Piazza

Keywords

Haploidentical HSCT, KIR receptors, anti-HLA antibodies

Abstract

In the present study we investigated the role of donor specific HLA antibodies (DSA) and donor KIR repertoire characteristics in a group of 18 patients affected by haemoglobinopathies who underwent haploidentical T cell depleted transplantation. Among these patients, 8 rejected the transplant while 10 had complete donor chimerism (CC). Five out of 8 patients (62.5%) who rejected graft had anti-HLA antibodies in the sera collected before transplant, while only 1 patient out of 10 (10%) with CC showed their presence (p=0,042). Notably, of the 5 HLA antibodies positive patients who rejected the graft 3 had DSA (2 for class I and 1 for class I and II) while none of the patients with CC had DSA. Among the 8 patients that experienced graft failure 4 were transplanted with a donor characterized by the lack of NK alloreactivity and 5 with a donor with a B content value <2. Although we analyzed a small cohort of patients, our data indicated that the presence of anti-HLA antibodies in patient sera, but not donor KIR characteristics, correlates with graft failure thus suggesting that analysis of anti-HLA antibodies should be taken into account in haploidentical transplant setting.

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