Cytotoxic crossmatch analysis before allo-SCT is a poor diagnostic tool for prediction of rejection.
The predictive value of cytotoxic crossmatch analysis before allo-SCT remains unclear. We retrospectively analyzed the clinical impact of cytotoxic T- and B-cell crossmatch testing before allo-SCT between January 2000 and June 2005. Cytotoxic crossmatches were performed in 157 patients receiving stem cells from matched unrelated donors or an HLA-A, -B or -DRB1 allele mismatched graft. Ninety patients are still alive. Eleven patients rejected their grafts. One of 11 patients with rejection was positive in a T-cell crossmatch before allo-SCT and 4 of 11 in B-cell crossmatches. T-cell crossmatches showed a sensitivity of 9% and a specificity of 97% compared with 36 and 86% for B-cell crossmatches. Positive T- and/or B-crossmatch before SCT had no predictive value for survival in this study as compared with patients with a negative crossmatch. In conclusion, the pretransplant cytotoxic T- and/or B-crossmatch is a poor predictor of rejection after allo-SCT.
Mattsson
J
J
Center for Allogeneic Stem Cell Transplantation, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden. Jonas.Mattsson@ki.se
Nordlander
A
A
Remberger
M
M
Uhlin
M
M
Holgersson
J
J
Ringdén
O
O
Hauzenberger
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D001402:B-Lymphocytes / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection / Q000276:immunology*; D006085:Graft Survival / Q000276:immunology; D006650:Histocompatibility Testing; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D033581:Stem Cell Transplantation / Q000379:methods*; D013601:T-Lymphocytes / Q000276:immunology*; D014184:Transplantation, Homologous / Q000276:immunology