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Donor leucocyte buffy coat infusion to patients with donor specific hla antibodies undergoing haploidentical hematopoietic stem cell transplantation
150
P159
Abstracts / Human Immunology 76 (2015) 38–167
DONOR LEUCOCYTE BUFFY COAT INFUSION TO PATIENTS WITH DONOR SPECIFIC HLA ANTIBODIES UNDERGOING HAPLOIDENTICAL HEMATOPOIETIC STEM CELL TRANSPLANTATION. Fleur Aung, Benjamin Lichtiger, Uday Popat, Richard E. Champlin, Stefan O. Ciurea. The University of Texas MD Anderson Cancer Center, Houston, TX, United States. Aim: Haploidentical stem cell transplantation (SCT) is an alternative option to treat high risk patients lacking HLA identical donors. When the patient has donor specific antibodies against the Haploidentical donor(s) and there is a need for the patient to undergo transplantation, the question arises as to whether to proceed with the transplantation. It is known that the detection of donor-directed HLA specific alloantibodies (DSA) in recipients of unrelated hematopoietic stem cell transplantations is predictive of graft failure. Method: Five ([5 Females: 0 Males], age median 45 years [range 24–63], diagnosis [AML (2)/Acute Erythroid Leukemia (1)/Myelofibrosis (1)/Aplastic Anemia (1)] patients with DSAs underwent Haploidentical SCT after undergoing a desensitization protocol of Rituxan/Plasma Exchange/IVG prior to transplant followed by an infusion of Donor Leucocyte buffy coat on Day-1. The buffy coat was prepared from an autologous unit of whole blood from the Haplo donor on Day-2. The blood was separated within 8 hours of collection into platelet rich plasma and packed red cells. Approximately 40–50 cc of red cells inclusive of the buffy coat was allowed to be collected in a platelet rich plasma bag. A second centrifugation separated the plasma from the red cells and the buffy coat component. The buffy coat component was then cross matched and infused to the patient. Results: All five patients engrafted median 33 (range 28–40) days post-transplant. Four are alive with median follow-up of 566 days from transplant (range 408–730 days). Two patients are in disease remission (553 and 600 days from transplant), the disease recurred in 2 patients (408 and 730 days from transplant) and one patient died of a viral infection on post-transplant Day 88. Conclusion: Although our numbers are small we believe that Leucocyte Buffy coat infusion after desensitization is a very promising approach for patients with DSAs undergoing Haploidentical stem cell transplantation.
P159
Abstracts / Human Immunology 76 (2015) 38–167
DONOR LEUCOCYTE BUFFY COAT INFUSION TO PATIENTS WITH DONOR SPECIFIC HLA ANTIBODIES UNDERGOING HAPLOIDENTICAL HEMATOPOIETIC STEM CELL TRANSPLANTATION. Fleur Aung, Benjamin Lichtiger, Uday Popat, Richard E. Champlin, Stefan O. Ciurea. The University of Texas MD Anderson Cancer Center, Houston, TX, United States. Aim: Haploidentical stem cell transplantation (SCT) is an alternative option to treat high risk patients lacking HLA identical donors. When the patient has donor specific antibodies against the Haploidentical donor(s) and there is a need for the patient to undergo transplantation, the question arises as to whether to proceed with the transplantation. It is known that the detection of donor-directed HLA specific alloantibodies (DSA) in recipients of unrelated hematopoietic stem cell transplantations is predictive of graft failure. Method: Five ([5 Females: 0 Males], age median 45 years [range 24–63], diagnosis [AML (2)/Acute Erythroid Leukemia (1)/Myelofibrosis (1)/Aplastic Anemia (1)] patients with DSAs underwent Haploidentical SCT after undergoing a desensitization protocol of Rituxan/Plasma Exchange/IVG prior to transplant followed by an infusion of Donor Leucocyte buffy coat on Day-1. The buffy coat was prepared from an autologous unit of whole blood from the Haplo donor on Day-2. The blood was separated within 8 hours of collection into platelet rich plasma and packed red cells. Approximately 40–50 cc of red cells inclusive of the buffy coat was allowed to be collected in a platelet rich plasma bag. A second centrifugation separated the plasma from the red cells and the buffy coat component. The buffy coat component was then cross matched and infused to the patient. Results: All five patients engrafted median 33 (range 28–40) days post-transplant. Four are alive with median follow-up of 566 days from transplant (range 408–730 days). Two patients are in disease remission (553 and 600 days from transplant), the disease recurred in 2 patients (408 and 730 days from transplant) and one patient died of a viral infection on post-transplant Day 88. Conclusion: Although our numbers are small we believe that Leucocyte Buffy coat infusion after desensitization is a very promising approach for patients with DSAs undergoing Haploidentical stem cell transplantation.