Platelet transfusion refractoriness attributable to HLA antibodies produced by donor-derived cells after allogeneic bone marrow transplantation from one HLA-antigen-mismatched mother.
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.
Hatakeyama
Naoki
N
Department of Pediatrics, Sapporo Medical University School of Medicine Hokkaido Red Cross Blood Center, Sapporo, Japan. nhatake@sapmed.ac.jp
Hori
Tsukasa
T
Yamamoto
Masaki
M
Inazawa
Natsuko
N
Iesato
Kotoe
K
Miyazaki
Toru
T
Ikeda
Hisami
H
Tsutsumi
Hiroyuki
H
Suzuki
Nobuhiro
N
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
D016824:Antigens, Human Platelet; D006680:HLA Antigens; D059811:HLA-DRB1 Chains; D007518:Isoantibodies