title: Platelet transfusion refractoriness attributable to HLA antibodies produced by donor-derived cells after allogeneic bone marrow transplantation from one HLA-antigen-mismatched mother.
abstract: PTR is a serious problem in patients being treated for hematologic disorders. Two patients with acute leukemia developed PTR after allogeneic BMT from one HLA-antigen-mismatched mother attributable to HLA antibodies, which could not be detected in their serum before BMT. HLA antibodies, whose specificity resembled that of each patient, were detected in each donor's serum. Each donor had probably been immunized during pregnancy by their partner's HLA antigens expressed by the fetus, consequently, transplanted donor-derived cells provoked HLA antibodies in each recipient early after BMT, and those HLA antibodies induced PTR. If the mothers are selected as donors for their children, they should be tested for the presence of HLA antibodies.
authors.affiliation: Department of Pediatrics, Sapporo Medical University School of Medicine Hokkaido Red Cross Blood Center, Sapporo, Japan. nhatake@sapmed.ac.jp
authors.forename: Naoki
authors.initials: N
authors.lastname: Hatakeyama
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Hori
authors.forename: Masaki
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Natsuko
authors.initials: N
authors.lastname: Inazawa
authors.forename: Kotoe
authors.initials: K
authors.lastname: Iesato
authors.forename: Toru
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Hisami
authors.initials: H
authors.lastname: Ikeda
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsutsumi
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Suzuki
mesh_terms: D016824:Antigens, Human Platelet / Q000097:blood; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006680:HLA Antigens / Q000276:immunology*; D059811:HLA-DRB1 Chains / Q000276:immunology; D006648:Histocompatibility; D006801:Humans; D007518:Isoantibodies / Q000096:biosynthesis*; D009035:Mothers; D010976:Platelet Count; D017713:Platelet Transfusion; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D011247:Pregnancy
chemical_list: D016824:Antigens, Human Platelet; D006680:HLA Antigens; D059811:HLA-DRB1 Chains; D007518:Isoantibodies