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SHR Neuro Cancer Cardio Lipid Metab Microb
Macher, S; Schallmoser, K; Staber, PB; Neumeister, P; Posch, U; Lanzer, G; Panzer, S.
Severe thrombocytopenia due to host-derived anti-HPA-1a after non-myeloablative allogeneic haematopoietic stem cell transplantation for multiple myeloma: a case report.
VOX SANG. 2005; 89(4): 257-260.
Doi: 10.1111/j.1423-0410.2005.00692.x
(- Case Report)
Web of Science
PubMed
FullText
FullText_MUG
- Leading authors Med Uni Graz
- Macher Susanne
- Co-authors Med Uni Graz
- Lanzer Gerhard
- Neumeister Peter
- Posch Ursula
- Schallmoser Katharina
- Staber Philipp
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- Abstract:
- BACKGROUND AND OBJECTIVES: Host- or donor-derived alloimmune thrombocytopenia can develop after non-myeloablative allogeneic haematopoietic stem cell transplantation (HSCT). We report the first case of host-derived HPA-1a antibodies. CASE REPORT: A 52-year-old male patient received HSCT from his human leucocyte antigen (HLA)-A, -B, -C, -DR identical brother after reduced intensity conditioning. Bilinear engraftment around day 12 was accompanied by a continuous decrease of platelet counts. We investigated for platelet antibodies because of a progressive decline of platelet counts and refractoriness to platelet transfusions. METHODS: The patient's serum was tested by enzyme-linked immunosorbent assay (ELISA), a solid phase assay and monoclonal antibody-specific immobilization of platelet antigens (MAIPA) assay. Recipient's DNA from the time before HSCT and donor's DNA were genotyped for human platelet antigens. RESULTS: Serum obtained on day 15 after HSCT reacted strongly with the donor's platelets due to host-derived anti-HPA-1a- and anti-HLA I antibodies. Serum samples from days 39, 45 and 65 after HSCT contained only anti-HLA I; no antibodies were detectable on day 149. Platelet counts increased on day 20 spontaneously. The decrease of the antibodies accompanied by the increase of the platelet counts suggests progressive elimination of residual host cells. CONCLUSIONS: The HPA-1a antibodies affected thrombopoietic engraftment and the success of platelet transfusions.
- Find related publications in this database (using NLM MeSH Indexing)
- Antigens, Human Platelet - immunology
- Autoantibodies - immunology
- Graft Survival - immunology
- Hematopoietic Stem Cell Transplantation -
- Humans -
- Male -
- Middle Aged -
- Multiple Myeloma - complications Multiple Myeloma - immunology Multiple Myeloma - therapy
- Platelet Transfusion -
- Purpura, Thrombocytopenic, Idiopathic - etiology Purpura, Thrombocytopenic, Idiopathic - immunology
- Transplantation, Homologous -
- Find related publications in this database (Keywords)
- anti-HPA-1a
- thrombocytopenia
- non-myeloablative
- HSCT