The influence of human platelet antigen match on the success of allogeneic peripheral blood progenitor cell transplantation following a reduced-intensity conditioning regimen.
BACKGROUND
Allogeneic transplantation in elderly patients requires a dose-reduced conditioning regimen. Owing to reduced-intensity conditioning, host- and donor-type immune responses may affect the early posttransplant period, whereas only later on donor-derived reactions may ensue. Mismatches in the HLA system are known to be detrimental for the outcome of transplantation. Mismatches between donor and recipient for human platelet antigens (HPAs) may also affect the success of transplantation owing to serving as minor histocompatibility antigens and therefore rendering recipients at risk for graft-versus-host disease (GVHD) or graft rejection and inhibition of thrombopoiesis attributed to platelet (PLT) antibodies.


METHODS
Therefore, the occurrence of GVHD, incidence of relapse, need of PLT support, and outcome by analysis of 45 donor-recipient pairs for HPA-1, -2, -3, and -5 allotypes and screening for PLT antibodies were evaluated before transplantation and again 1 year thereafter.


RESULTS
Mismatches within the HPA system were not associated with an increased occurrence of transplant-related mortality or GVHD, the onset of thrombopoiesis, the frequency of PLT transfusions, or the incidence of relapse. Neither were settings of homozygous donors versus heterozygous recipients (graft-vs.-host direction) nor homozygous recipients versus heterozygous donors (host-vs.-graft direction) associated with any adverse effects on the outcome of the transplantation.


CONCLUSIONS
Thus, the HPA match does not affect the outcome of transplantation after reduced-intensity conditioning.
Leitner
Gerda C
GC
Clinic for Blood Group Serology and Transfusion Medicine and the First Medical Department, Bone Marrow Transplantation Unit, University of Vienna, Vienna, Austria.
Stiegler
Gabriele
G
Kalhs
Peter
P
Greinix
Hildegard T
HT
Rabitsch
Werner
W
Sillaber
Christian
C
Hoecker
Paul
P
Panzer
Simon
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D016824:Antigens, Human Platelet / Q000276:immunology*; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000401:mortality; D006085:Graft Survival / Q000276:immunology; D006086:Graft vs Host Disease / Q000276:immunology / Q000401:mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000401:mortality*; D012008:Recurrence; D012189:Retrospective Studies; D034061:Thrombopoiesis / Q000276:immunology; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous
D016824:Antigens, Human Platelet