Evidence map›Paper›PMID 40085951›Full record

ArticleBlood advances2025

Impact of HLA alloimmunization on clinical outcomes of severe aplastic anemia treated with immunosuppressive therapy.

Jibran Durrani, Leonard N Chen, Ruba N Shalhoub, Valentina Baez, Joshua Glass, Nu Ri Cha, Xiaoyang Ma, Zhijie Wu, Shouguo Gao, Jennifer Lotter and 6 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Blood advances, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Jibran DurraniHematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.ORCID 0000-0001-9172-4706
Leonard N ChenBlood Services Section, Department of Transfusion Medicine, National Institutes of Health Clinical Center, Bethesda, MD.
Ruba N ShalhoubOffice of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.
Valentina BaezLaboratory Services Section, Department of Transfusion Medicine, National Institutes of Health Clinical Center, Bethesda, MD.ORCID 0000-0003-0067-1325
Joshua GlassHematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.ORCID 0009-0003-1575-2192
Nu Ri ChaLaboratory Services Section, Department of Transfusion Medicine, National Institutes of Health Clinical Center, Bethesda, MD.
Xiaoyang MaOffice of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.
Zhijie WuHematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.ORCID 0000-0003-3984-0819
Shouguo GaoHematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.
Jennifer LotterHematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.
Olga RiosHematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.
Colin O WuOffice of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.
Willy A FlegelLaboratory Services Section, Department of Transfusion Medicine, National Institutes of Health Clinical Center, Bethesda, MD.
Neal S YoungHematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.
Emma M GroarkeHematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.ORCID 0000-0002-4648-5926
Bhavisha A PatelHematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.ORCID 0000-0002-2974-7701

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

abstractImmune aplastic anemia (iAA) frequently results in transfusion dependence on platelets and packed red blood cells, increasing the risk for complications. The most common immune-mediated cause for platelet-transfusion refractoriness is alloimmunization with HLA antibody (Ab) to nonself class I antigens. The clinical impact of the HLA alloimmunization has not been well studied in patients with iAA. We investigated the clinical relevance of HLA alloimmunization in our large cohort of patients with iAA from 5 prospective trials and correlated with disease outcomes. Of 444 patients with severe AA treated with immunosuppressive therapy (IST), 99 (22%) had HLA alloimmunization. The presence of HLA Ab was associated with shorter overall survival, reduced responses to IST and higher risk of clonal evolution. Our data suggest that HLA alloimmunization is a marker of disease outcome. Furthermore, using single-cell RNA sequencing, we show enhanced activation of both complement-mediated pathways and the adaptive immune system in alloimmunized patients, indicating an interconnection between immune compartments.

Indexed as

Anemia, AplasticHLA AntigensImmunosuppression TherapyImmunosuppressive AgentsIsoantibodiesAdolescentAdultChildFemaleHumansMaleMiddle AgedTreatment OutcomeYoung AdultHLA AntigensImmunosuppressive AgentsIsoantibodies

Identifiers

PMID40085951
PMCPMC12155784

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.