The impact of pre‐transplant anti‐HLA antibodies in transplants from HLA‐identical sibling donors: A multicenter study

Abstract

Few studies have performed comparative analysis of the outcome of hematopoietic stem cell transplantation from HLA‐identical sibling donors (ISD‐HSCT) in patients with or without anti‐HLA Abs. In this study we retrospectively collected data from a multicenter study to analyze the distribution and impact of the pre‐existing anti‐HLA Abs in ISD‐HSCT. Among 402 recipients, 111 were positive for anti‐HLA Abs. Gender, time from diagnosis to transplantation and distribution of primary disease might be risk factors for the occurrence of anti‐HLA Abs. We found that patients with anti‐HLA Abs had delayed neutrophil engraftment and were more vulnerable to experience Cytomegalovirus (CMV) reactivation. The presence of anti‐HLA Abs was proved to be an independent risk factor for neutrophil engraftment (HR 1.42 95% CI 1.13–1.80, p = 0.003) and CMV reactivation (HR 2.03 95% CI 1.19–3.46, p = 0.009). We found that anti‐HLA Abs have a negative impact on the prognosis in the early period after transplantation from sibling donors and anti‐HLA Abs was also an independent risk factor for the overall survival (OS) at 180 days (HR 2.32, 95% CI 1.03–5.27, p = 0.042) among female recipients. In conclusion, anti‐HLA Abs have a negative impact on the prognosis early after ISD‐HSCT.