ArticleTherapeutic advances in hematology2026
Early-onset de novo donor-specific anti-HLA antibodies may contribute to poor graft function following haploidentical transplantation for myelodysplastic syndrome: a rare case presentation.
Article in Therapeutic advances in hematology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
In haploidentical hematopoietic stem cell transplantation, preexisting donor-specific anti-HLA antibodies (DSAs) in recipients have been associated with graft rejection, poor graft function (PGF), and unfavorable clinical outcomes, with relatively well-established consensus strategies for its management. However, reports on the emergence of de novo DSAs after transplantation and the corresponding therapeutic approaches remain limited. Here, we describe a case of a 14-year-old patient with myelodysplastic syndrome who developed de novo DSAs as early as day 15 post-transplantation, with a peak mean fluorescence intensity of 12,280, which was associated with PGF. To reduce DSA levels, plasma exchange combined with intravenous immunoglobulin and rituximab was administered, followed by a series of interventions including mesenchymal stem cell infusion. These measures facilitated graft function recovery, controlled transplant-related complications, and ultimately led to successful engraftment.
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