ASHI Quarterly

Third Quarter 2015

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17 ASHI Quarterly Third Quarter 2015 C U R R E N T L I T E R A T U R E R E V I E W Conclusions Based on current literature, it appears that pre-existing antibodies in mismatched (haploidentical, mismatched unrelated, mismatched cord blood) SCT patients can delay and/or decrease the engraftment process and even result in complete graft failure Conversely, transfer of sensitized B cells from the BMT/HSCT donors that have HLA-specific antibodies against mismatched HLA antigens of the recipients (DRSA) can cause B cell-mediated GVHD Hence, HLA antibody monitoring of BMT/HSCT patients and donors may be helpful in choosing the optimal donor/recipient pair When there is no choice except a mismatched BMT/HSCT and the recipient or donor has reactive anti-HLA antibodies, desensitization or treatment with rituximab may bring about a favorable outcome References 1 Spellman S, Bray R, Rosen-Bronson S, et al The detection of donor-directed, HLA-specific alloantibodies in recipients of unrelated hematopoietic cell transplantation is predictive of graft failure Blood. 2010;115:2704–2708 2 Ciurea SO, Thall PF, Wang X, et al Donor-specific anti-HLAAbs and graft failure in matched unrelated donor hematopoietic stem cell transplantation Blood. 2011;118:5957–5964 3 Takanashi M, Atsuta Y, Fujiwara K, et al The impact of anti- HLA antibodies on unrelated cord blood transplantations Blood. 2010;116:2839–2846 4 Cutler C, Kim HT, Sun L, et al Donor-specific anti-HLA antibodies predict outcome in double umbilical cord blood transplantation Blood. 2011;118:6691–6697 5 Ciurea SO, de Lima M, Cano P, et al High risk of graft failure in patients with anti-HLA antibodies undergoing haploidentical stem- cell transplantation Transplantation. 2009;88:1019–1024 6 Yoshihara S, Maruya E, Taniguchi K, et al Risk and prevention of graft failure in patients with preexisting donor-specific HLA antibodies undergoing unmanipulated haploidentical SCT Bone Marrow Transplant. 2012;47:508–515 7 Gladstone DE, Zachary AA, Fuchs EJ, et al Partially mismatched transplantation and human leukocyte antigen donor-specific antibodies Biol Blood Marrow Transplant. 2013;19:647-52 8 Taniguchi K, Yoshihara S, Maruya E, et al Donor-derived HLA antibody production in patients undergoing SCT from HLA antibody-positive donors Bone Marrow Transplant. 2012;47:1338-42 9 Shimabukuro-Vornhagen A, Hallek MJ, Storb RF, et al The role of B cells in the pathogenesis of graft-versus-host disease Blood. 2009;114:4919-27 10 Hows J, Beddow K, Gordon-Smith E, et al Donor-derived red blood cell antibodies and immune hemolysis after allogeneic bone marrow transplantation Blood. 1986;67:177–181 11 Toren A, Dacosta Y, Manny N, Varadi G, Or R, Nagler A Passenger B-lymphocyte induced severe hemolytic disease after allogeneic peripheral blood stem cell transplantation Blood. 1996;87:843–844 12 Lee HJ, Gulbis A, De Padua Silva L, et al Rituximab for passenger lymphocyte syndrome associated with allogeneic SCT Bone Marrow Transplant. 2008;42:67–69; Adams BR, Miller AN, Costa LJ Self- limited hemolysis due to anti-D passenger lymphocyte syndrome in allogeneic hematopoietic stem cell transplantation Bone Marrow Transplant. 2010;45:772–773 13 Kamble R, Oholendt M, Carrum G Rituximab responsive refractory acute graft-versus-host disease Biol Blood Marrow Transplant. 2006;12(11):1201-1202 14 Ratanatharathorn V, Logan B, Wang D, et al Prior rituximab correlates with less acute graft-versus-host disease and better survival in B-cell lymphoma patients who received allogeneic peripheral blood stem cell transplantation Br J Haematol. 2009;145(6):816-824 15 KhouriI F, McLaughlinP, Saliba RM, et al Eight-year experience with allogeneic stem cell transplantation for relapsed follicular lymphoma after nonmyeloablative conditioning with fludarabine, cyclophosphamide, and rituximab Blood. 2008;111(12):5530-5536 16 Kebriaei P, Saliba RM, MaC, et al Allogeneic hematopoietic stem cell transplantation after rituximab-containing myeloablative preparative regimen for acute lymphoblastic leukemia Bone Marrow Transplant. 2006;38(3):203-209 17 Shimoni A, Hardan I, Avigdor A, et al Rituximab reduces relapse risk after allogeneic and autologous stem cell transplantation in patients with high-risk aggressive non-Hodgkin's lymphoma Br J Haematol. 2003;122(3):457-464 18 Kharfan-Dabaja MA, Tate C, Perkins J, et al Administration of rituximab is feasible and does not affect engraftment of allograft recipients with advanced CD20+ malignancies [abstract 3016] Blood. 2007;110(11) 19 Sahaf B, Chen G, Heydari K, Arai S, Miklos D Rituximab infusion two months after hct decreases alloreactive b cell responses while recipient plasma cells persist [abstract 2234] Blood. 2008;112(11) 20 Iori AP, Torelli GF, De Propris MS, et al B-cell concentration in the apheretic product predicts acute graft-versus-host disease and treatment-related mortality of allogeneic peripheral blood stem cell transplantation Transplantation. 2008;85(3):386-390 Corresponding Author Information Siva Kanangat, PhD, D (ABHI) Director & Associate Professor Histocompatibility & Immunogenetics Department of Pathology Rush University Medical Center • Chicago, IL 60612 Phone: 312-942-2054 • Email: Sivadasan_kanangat@rush edu Recommended Reading: Yoshihara S, Taniguchi K, Ogawa H, Saji H The role of HLA antibodies in allogeneic SCT: is the 'type-and-screen' strategy necessary not only for blood type but also for HLA? Bone Marrow Transplant. 2012; doi: 10 1038/bmt 2011 249

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