Donor Specific Anti-HLA Antibody and Risk of Graft Failure in Haploidentical Stem Cell Transplantation

Table 1

DSAs and transplant outcomes.

Reference	Donor	Test		%Anti-HLA+	%DSA+	Graft outcome (DSA+/DSA−)	Comment
Ciurea et al. 2009 [22]	TCD HaploSCT	Luminex SA	24	NA	21	GF was 75% versus 5% ()
Spellman et al. 2010 [23]	MMUD	FlowPRA, Luminex SA	115	37	8.7	24% of GF group had DSAs versus 1% of control group that had DSAs
Ciurea et al. 2011 [3]	MUD, 1 Ag MMUD	Luminex SA	592	21	1.4	GF was 37.5% versus 2.7% ()
Yoshihara et al. 2012 [48]	HaploSCT	Luminex SA	79	20	14	GF was 27% versus 4%; CI of neutrophil engraftment was 61.9% versus 94.4%, ()	(i) 5 patients were desensitized and 3/5 engrafted; (ii) 67, 5, and 7 patients were antibody-negative, non-DSA-positive, and DSA-positive after desensitization
Ciurea et al. 2015 [46]	HaploSCT	Luminex SA	122	NA	18	GF was 32% versus 4% ()
Chang et al. 2015 [49]	HaploSCT	NA	345	25.2	11.3	Primary graft rejection was 20% versus 0.3% (); Primary poor graft function was 27.3% versus 1.9% ()
Takanashi et al. 2010 [50]	Single UCB	FlowPRA, Luminex SA	386	23.1	5	CI of neutrophil engraftment was 32% versus 83% ()	Patients with DSA had significantly lower EFS and OS compared with no DSA
Brunstein et al. 2011 [51]	Double UCB	Luminex SA	126	41	24% had DSAs target to 1 UCB, 12% had DSA target to both UCB	GF was 17% versus 22%
Cutler et al. 2011 [24]	Double UCB	Luminex SA	73	NA	24.6	GF was 18.2% and 57% in patients who had DSAs against 1 and 2 UCB, respectively, versus 5.5% in patients without DSAs ()	The rates of death or relapse within 100 days for the group of patients without DSAs, with DSAs against a single UCB unit, or DSAs against both UCB units were 23.6%, 36.4%, and 71.4%, respectively ()
Ruggeri et al. 2013 [39]	Single UCB, double UCB	Luminex SA	294	21	4.7	GF was 56% versus 23%	The presence of DSA was associated with lower survival (42% versus 29%; ).

MMUD: mismatched unrelated donor; MUD: matched unrelated donor; GF: graft failure; DSA: donor specific antibody; TCD HaploSCT: T cell-depleted haploidentical stem cell transplant; UCB: umbilical cord blood; EFS: event-free survival; OS: overall survival; NA: not available.