Bortezomib alone fails to decrease donor specific anti-HLA antibodies: 4 case reports.
In renal transplant recipients, the persistence of donor specific anti-HLA antibodies (DSA) associated with antibody-mediated graft injuries predicts evolution toward chronic humoral rejection and lower graft survival. Targeting plasma cells with the proteasome inhibitor bortezomib may be a promising desensitization strategy. We evaluated the in vivo efficacy of one cycle of bortezomib (1.3 mg/m2 x 4 doses), used as the sole desensitization therapy, in four renal transplant recipients experiencing sub-acute antibody-mediated rejection with persisting DSA (>2000 [Mean Fluorescence Intensity] MFI). Bortezomib treatment did not significantly decrease DSA MFI within the 270-day post-treatment period in any patient. In conclusion, one cycle of bortezomib alone does not decrease DSA levels in sensitized kidney transplant recipients.
Université Paris Descartes, Paris, France.
Rebecca
R
Sberro-Soussan
Julien
J
Zuber
Caroline
C
Suberbielle-Boissel
Christophe
C
Legendre
D000328:Adult; D001897:Boronic Acids / Q000627:therapeutic use*; D000069286:Bortezomib; D005260:Female; D006680:HLA Antigens / Q000276:immunology*; D006683:HLA-DQ Antigens / Q000276:immunology; D006801:Humans; D007518:Isoantibodies / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011480:Protease Inhibitors / Q000627:therapeutic use*; D011719:Pyrazines / Q000627:therapeutic use*; D017211:Treatment Failure; D016896:Treatment Outcome
D001897:Boronic Acids; D006680:HLA Antigens; D006683:HLA-DQ Antigens; D007518:Isoantibodies; D011480:Protease Inhibitors; D011719:Pyrazines; D000069286:Bortezomib