Successful Salvage Therapy by Second Haploidentical Allogeneic Hematopoietic Stem Cell Transplantation in a Severe Aplastic Anemia Patient Presenting Donor-Specific Anti-HLA Antibodies After Graft Failure From Matched Sibling Donor HSCT: A Case Report and Review.

Abstract

BACKGROUND:

Hematopoietic stem cell transplantation (HSCT) is potentially curative for severe aplastic anemia (SAA). Graft failure (GF) remains a life-threatening complication after HSCT. Preexisting anti-HLA antibodies, especially HLA-specific antibodies (DSA), have been demonstrated as a risk of GF.

CASE PRESENTATION:

This report describes a woman with acquired SAA who presented with anti-HLA antibodies and GF. After the treatment of anti-HLA antibodies, engraftment was achieved through a second alternative donor HSCT. This work complied with the Declaration of Helsinki and the Declaration of Istanbul.

CONCLUSIONS:

Based on our experience in treating this case, we hold that the presence of preoperative anti-HLA antibodies could discount the efficacy of HSCT and anti-HLA antibody screening should be performed before HSCT. Additionally, a second HSCT is feasible to prolong survival.

• Authors: Yejun Si, Xingxia Zhang, Meiru Bian, Guoqiang Lin, Li Wang, Miao Wang, Yanming Zhang
• Journal: Transplantation proceedings (Transplant Proc) Vol. 53 Issue 4 Pg. 1350-1354 (May 2021) ISSN: 1873-2623 [Electronic] United States
• PMID: 33752903 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

Chemical References

• Antibodies
• HLA Antigens

Topics

• Adult
• Anemia, Aplastic (pathology, therapy)
• Antibodies (blood)
• Female
• Graft vs Host Disease (diagnosis, etiology, prevention & control)
• HLA Antigens (immunology)
• Haploidy
• Hematopoietic Stem Cell Transplantation (adverse effects)
• Humans
• Pancytopenia (diagnosis, etiology)
• Plasma Exchange
• Salvage Therapy (methods)
• Severity of Illness Index
• Transplantation, Homologous