The European Society for Blood and Marrow Transplantation (EBMT) Consensus Guidelines for the Detection and Treatment of Donor-specific Anti-HLA Antibodies (DSA) in Haploidentical Hematopoietic Cell Transplantation.
Stefan O Ciurea, Kai Cao, Marcelo Fernandez-Vina, Piyanuch Kongtim, Monzr Al Malki, Ephraim Fuchs, Leo Luznik, Xiao-Jun Huang, Fabio Ciceri, Franco Locatelli, Franco Aversa, Luca Castagna, Andrea Bacigalupo, Massimo Martelli, Didier Blaise, Rupert Handgretinger, Denis-Claude Roy, Paul O'Donnell, Asad Bashey, Hillard M Lazarus, Karen Ballen, Bipin N Savani, Mohamad Mohty, Arnon Nagler
Author Information
Stefan O Ciurea: The University of Texas MD Anderson Cancer Center, Houston, TX, USA. sciurea@mdanderson.org.
Kai Cao: The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Marcelo Fernandez-Vina: Stanford University, Stanford, CA, USA.
Monzr Al Malki: Department of Hematology and HCT, City of Hope National Medical Center, Duarte, CA, USA.
Ephraim Fuchs: Division of Hematologic Malignancies, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA.
Leo Luznik: Division of Hematologic Malignancies, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA.
Xiao-Jun Huang: Institute of Hematology, Peking University People's Hospital, Beijing, China.
Fabio Ciceri: Hematology and BMT Unit, San Raffaele Scientific Institute, Milan, Italy.
Franco Locatelli: Department of Pediatric Hematology and Oncology, IRCCS Ospedale Pediatrico Bambino Gesu, Rome, Italy.
Franco Aversa: Hematology and BMT Unit, University of Parma, Parma, Italy.
Luca Castagna: Hematology Department, Humanitas Clinical and Research Center, Milan, Italy.
Andrea Bacigalupo: Instituto di Ematologia, Fondazione Policlinico Universitario Gemelli, Universita' Cattolica del Sacro Cuore, Roma, Italy.
Massimo Martelli: University of Perugia, Perugia, Italy.
Didier Blaise: Departement D'Hematologie, Programme de Transplantation et de Therapie Cellulaire, Centre de Recherche en Cancerologie de Marseille, Institut Paoli Calmettes, Marseille, France.
Rupert Handgretinger: Department of Hematology and Oncology, Children's University Hospital, Tubingen, Germany.
Denis-Claude Roy: Blood and Marrow Transplantation Program, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, Quebec, Canada.
Paul O'Donnell: Massachusetts General Hospital Cancer Center, Boston, MA, USA.
Asad Bashey: BMT Program at Northside Hospital, Atlanta, GA, USA.
Hillard M Lazarus: Case Western Reserve University, Cleveland, OH, USA.
Karen Ballen: University of Virginia Health System, Charlottesville, VA, USA.
Bipin N Savani: Vanderbilt University Medical Center, Nashville, TN, USA.
Mohamad Mohty: Hopital Saint-Antoine, Paris, France.
Arnon Nagler: Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Haploidentical donors are now increasingly considered for transplantation in the absence of HLA-matched donors or when an urgent transplant is needed. Donor-specific anti-HLA antibodies (DSA) have been recently recognized as an important barrier against successful engraftment of donor cells, which can affect transplant survival. DSA appear more prevalent in this type of transplant due to higher likelihood of alloimmunization of multiparous females against offspring's HLA antigens, and the degree of mismatch. Here we summarize the evidence for the role of DSA in the development of primary graft failure in haploidentical transplantation and provide consensus recommendations from the European Society for Blood and Marrow Transplant Group on testing, monitoring, and treatment of patients with DSA receiving haploidentical hematopoietic progenitor cell transplantation.
