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 Fernadez-Vina , Piyanuch Kongtim , Monzr Al Malki , Ephraim Fuchs , Leo Luznik , Xiao-Jun Huang , Fabio Ciceri (1) , Franco Locatelli (2) , Franco Aversa (3) , Luca Castagna (4, 5, 6) , Andrea Bacigalupo (7, 8) , Massimo Martelli , Didier Blaise (9, 10) , Rupert Handgretinger , Denis-Claude Roy , Paul O'Donnell , Asad Bashey , Hillard M. Lazarus , Karen Ballen , Bipin N. Savani , Mohamad Mohty (11) , Arnon Nagler (12)

1 IRCCS Ospedale San Raffaele [Milan, Italy]
2 Santa Lucia Foundation, IRCSS, Rome
3 Department of Clinical and Experimental Medicine
4 Département d'Hématologie [Marseille]
5 Unité de Transplantation et de Thérapie Cellulaire [Marseille]
6 Department of Hemato-oncology - Transplant Unit [Milano, Italy]
7 Department of Hematology II [Genova, Italy]
8 Unicatt - Università cattolica del Sacro Cuore = Catholic University of the Sacred Heart [Roma]
9 Service d’Hématologie [Institut Paoli Calmettes, Marseille]
10 CRCM - Centre de Recherche en Cancérologie de Marseille
11 CRCNA - Centre de Recherche en Cancérologie Nantes-Angers
12 UPMC - Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie

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.

Domains: Life Sciences [q-bio]

Stefan O. Ciurea, Kai Cao, Marcelo Fernadez-Vina, Piyanuch Kongtim, Monzr Al Malki, et al.. 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. Bone Marrow Transplantation, 2018, 53 (5), pp.521-534. ⟨10.1038/s41409-017-0062-8⟩. ⟨hal-02143577⟩