Increased presence of anti-HLA antibodies early after allogeneic granulocyte colony-stimulating factor-mobilized peripheral blood hematopoietic stem cell transplantation compared with bone marrow transplantation.
We have recently shown that the use of allogeneic granulocyte colony-stimulating factor (G-CSF)-mobilized peripheral blood hematopoietic stem cell transplantation (PBHSCT), as compared with bone marrow transplantation (BMT), is associated with increased titers of antibodies (Abs) directed against red blood cell ABO antigens. To further evaluate the influence of a G-CSF-mobilized PBHSCT graft on alloimmune Ab responses, we examined the frequency of anti-HLA Abs after transplantation in the setting of the same randomized study, comparing PBHSCT with BMT in adults. Anti-HLA Ab presence was determined by complement-dependent cytotoxicity assay (CDC) and flow cytometry in the recipient before and 30 days after transplantation as well as in the donor before graft donation. The use of PBHSCT was significantly associated with increased detection of anti-HLA immunoglobulin G (IgG) Abs early after transplantation as evidenced by flow cytometry (11 of 24 versus 4 of 27 transplant recipients, P =.03) and, less so, by CDC (5 of 24 versus 1 of 27 transplant recipients, P =.09). The difference between PBHSCT and BMT was further heightened when analysis was restricted to anti-HLA IgG Ab-negative donor/recipient pairs. In such a setting, early anti-HLA Ab was never detected after BMT but was repeatedly detected after PBHSCT (flow cytometry, 6 of 18 versus 0 of 17 transplant recipients, P =.02; CDC, 4 of 23 versus 0 of 26 transplant recipients, P =.04). Importantly, the PBHSCT-associated increase in anti-HLA Ab detection was observed despite a reduction in the median number of platelet-transfusion episodes per patient in PBHSC transplant versus BM transplant recipients (3 platelet-transfusion episodes [range, 1-21] in PBHSCT group vs 6 platelet-transfusion episodes [range, 3-33] in the BMT group; P =.02). In conclusion, this study strongly suggests that G-CSF-mobilized PBHSCT results in an increased incidence of circulating anti-HLA Abs and further confirms that the use of such a graft alters alloimmune Ab responses.
Lapierre
Valérie
V
Unité de Thérapie Tissulaire, Cellulaire et Génique, INSERM E 0119/UPRES EA 2284, Etablissement Français du Sang Bourgogne-Franche-Comté, Besançon, France.
Aupérin
Anne
A
Tayebi
Hakim
H
Chabod
Jacqueline
J
Saas
Philippe
P
Michalet
Mauricette
M
François
Sylvie
S
Garban
Frédéric
F
Giraud
Christine
C
Tramalloni
Dominique
D
Oubouzar
Nadia
N
Blaise
Didier
D
Kuentz
Matthieu
M
Robinet
Eric
E
Tiberghien
Pierre
P
D000328:Adult; D016026:Bone Marrow Transplantation / Q000276:immunology; D003601:Cytotoxicity Tests, Immunologic; D005260:Female; D005434:Flow Cytometry; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology*; D006680:HLA Antigens / Q000276:immunology*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007518:Isoantibodies / Q000097:blood*; D008297:Male; D008875:Middle Aged; D017713:Platelet Transfusion; D020858:Tissue and Organ Harvesting / Q000379:methods; D014184:Transplantation, Homologous
D006680:HLA Antigens; D007074:Immunoglobulin G; D007518:Isoantibodies; D016179:Granulocyte Colony-Stimulating Factor