Journal of Applied Hematology

CASE REPORT
Year
: 2019  |  Volume : 10  |  Issue : 2  |  Page : 67--69

Desensitization with plasma exchange in a patient with human leukocyte antigen donor-specific antibodies before T-cell-replete haploidentical hematopoietic stem cell transplantation


Rasika Dhawan Setia1, Mitu Dogra1, Divya Doval2, Sanjeev Kumar Sharma2, Dharma Choudhary2, Anil Handoo1 
1 Department of Hematology and Transfusion Medicine, BLK Super Speciality Hospital, New Delhi, India
2 Department of Hemato-Oncology and BMT, BLK Super Speciality Hospital, New Delhi, India

Correspondence Address:
Dr. Rasika Dhawan Setia
Department of Hematology and Transfusion Medicine, BLK Super Speciality Hospital, New Delhi
India

The presence of human leukocyte antigen (HLA) donor-specific antibodies (DSAs) increases the risk of graft failure in T-cell-replete haploidentical hematopoietic stem cell transplantation (haploidentical-HSCT). We report a case of a 20-year-old male with high-risk thalassemia major who received a haploidentical-HSCT from his mother. Pretransplant recipient screening examination showed positive DSA levels against class I and class II HLAs. The patient underwent a desensitization program consisting of plasma exchange and polyvalent intravenous immunoglobulins. This protocol resulted in the disappearance of DSA class I and reduction in Mean Fluorescence Intensity (MFI) class II antibodies. Engraftment was prompt with stable full donor chimerism. This case report suggests that the adopted scheme is safe for reducing DSA levels and facilitating donor engraftment in patients scheduled for haploidentical-HSCT, though it needs evaluation in a large cohort of patients.


How to cite this article:
Setia RD, Dogra M, Doval D, Sharma SK, Choudhary D, Handoo A. Desensitization with plasma exchange in a patient with human leukocyte antigen donor-specific antibodies before T-cell-replete haploidentical hematopoietic stem cell transplantation.J Appl Hematol 2019;10:67-69


How to cite this URL:
Setia RD, Dogra M, Doval D, Sharma SK, Choudhary D, Handoo A. Desensitization with plasma exchange in a patient with human leukocyte antigen donor-specific antibodies before T-cell-replete haploidentical hematopoietic stem cell transplantation. J Appl Hematol [serial online] 2019 [cited 2019 Jul 21 ];10:67-69
Available from: http://www.jahjournal.org/article.asp?issn=1658-5127;year=2019;volume=10;issue=2;spage=67;epage=69;aulast=Setia;type=0