肿瘤细胞治疗研究
英文原题：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.
在单倍体造血干细胞移植中，受者体内预存的供者特异性抗HLA抗体（DSAs）与移植物排斥、移植物功能不良（PGF）及不良临床结局相关，其管理已有相对成熟的共识策略。
在单倍体相合造血干细胞移植中，受者移植前已存在供者特异性抗HLA抗体（DSA）与移植物排斥、移植物功能不良（PGF）及不良临床结局相关，目前已有相对成熟的管理共识。然而，关于移植后新发DSA及相应治疗方法的报道仍有限。本文报告一例14岁骨髓增生异常综合征患者，其移植后第15天即出现新发DSA，峰值平均荧光强度为12,280，并与PGF相关。为降低DSA水平，患者接受血浆置换联合静脉注射免疫球蛋白及利妥昔单抗，随后还接受包括间充质干细胞输注在内的一系列干预。上述措施促进移植物功能恢复、控制移植相关并发症，并最终实现成功植入。
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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