Tohoku J. Exp. Med., 2023 October, 261(2)

Umbilical Cord Blood Transplantation for Myelodysplastic Syndromes with Donor-Specific Anti-HLA Antibodies against HLA-DP

Yusuke Uchibori,¹ Koichi Onodera,¹ Yasushi Onishi,¹ Hiroka Komatsu,¹ Kenta Takenaka,¹ Yoshihiro Narumi,¹ Tatsuya Watanabe,¹ Hiroshi Nakamura,¹ Kazuki Sakurai,¹ Kazuki Hashimoto,¹ Kyoko Inokura,¹ Satoshi Ichikawa,¹ Noriko Fukuhara,¹ Hisayuki Yokoyama¹ and Hideo Harigae¹

¹Department of Hematology, Tohoku University Hospital, Sendai, Miyagi, Japan

The presence of donor-specific anti-human leukocyte antigen (HLA) antibodies (DSAs) against anti-HLA-A, -B, -C, and -DRB1 in HLA-mismatched hematopoietic stem cell transplantation (HSCT) is associated with graft failure. DSAs against HLA-A, -B, -C, and -DRB1 with a mean fluorescence intensity (MFI) of greater than > 1,000 was shown to increase the risk of graft failure in single-unit umbilical cord blood transplantation (UCBT). Nevertheless, the impact of DSAs against HLA-DP or -DQ on transplantation outcomes is not fully understood. In this report, we present a case of UCBT in a patient with myelodysplastic syndrome who was positive for DSAs against HLA-DP with MFI of 1,263 before UCBT but successfully achieved neutrophil engraftment. If HLA-DP or -DQ is mismatched in UCBT, evaluating DSAs against HLA-DP or -DQ is crucial to avoid graft failure. However, the criteria for DSAs against HLA-A, -B, -C, and -DRB1 may not be directly applicable to those against HLA-DP or -DQ.

Key words —— donor-specific anti-HLA antibody; graft failure; HLA-DP; mean fluorescence intensity; umbilical cord blood transplantation

© 2023 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2023 October, 261(2), 123-127.

Correspondence: Koichi Onodera, Department of Hematology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.

e-mail: koichi.onodera.d6@tohoku.ac.jp