ArticleBone marrow transplantation2026
Treatment outcome and efficacy of desensitization strategies for immunized-PTR in hematological malignancies before hematopoietic stem cell transplantation.
Article in Bone marrow transplantation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07635511 (Acalabrutinib Maleate Monotherapy or in Combination With Bortezomib for Eliminating HLA Antibodies in Patients With Hematologic Malignancies and Platelet Transfusion Refractoriness), which is not on this map. Not yet cited in PubMed.
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Acalabrutinib Maleate Monotherapy or in Combination With Bortezomib for Eliminating HLA Antibodies in Patients With Hematologic Malignancies and Platelet Transfusion Refractoriness: a Multicenter, Randomized Controlled Study
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Abstract
Immunized platelet transfusion refractoriness (immunized-PTR) correlates with poor outcomes in hematological malignancies (HM) patients during allogeneic hematopoietic stem-cell transplantation (allo-HSCT). The efficacy and outcomes of desensitization with rituximab (RTX) and therapeutic plasma exchange (TPE) for immunized-PTR remain controversial. The study included 83 Ab-negative non-PTR patients and 65 patients with severe immunized-PTR who underwent allo-HSCT. Based on pre-transplant desensitization, 30 and 35 patients were classified into the Ab-positive PTR-treatment and Ab-positive PTR groups. After desensitization, HLA antibodies were decreased (71 ± 19 vs. 26 ± 22, P <0.01), 14h-corrected count increment (CCI) was increased(14.64 ± 5.36 vs. 2.00 ± 1.33, P <0.001), and the cumulative incidence of platelet engraftment at day 21 and 6 months was higher (93.3% vs. 82.9% in Ab-positive PTR group, P = 0.0002 and 90.0% vs. 67.1% in Ab-positive PTR group, P = 0.0005), significantly. Compared to Ab-positive PTR groups, desensitization leads to a better prognosis in Ab-positive PTR-treatment group (3-year OS: 93.3% vs. 47.0%, P <0.0001; 3-year LFS: 83.0% vs. 48.0%,respectively, P <0.0001). Multivariable analysis revealed that desensitization was independently associated with better OS (HR, 0.068; 95%CI, 0.014-340; P = 0.001) and LFS (HR, 0.090; 95%CI, 0.023-358; P = 0.001) for PTR patients. This result indicates that immunized-PTR is associated with poor outcomes in HM patients after allo-HSCT, and desensitization with RTX and TPE achieve favorable outcomes.
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