The clinical relevance of pre-formed anti-HLA and anti-MICA antibodies after cord blood transplantation in children

PLoS One. 2013 Aug 19;8(8):e72141. doi: 10.1371/journal.pone.0072141. eCollection 2013.


Preformed anti-HLA antibodies (AHA) are known to be associated with delayed engraftment and reduced overall survival after adult hematopoietic stem cell transplantation. However, limited data is available in pediatric patients. In this study, we explored the role of AHA on clinical outcomes in 70 pediatric patients who received a single unit of HLA mismatch cord blood for hematologic malignancies, immunodeficiencies or metabolic diseases. The presence of AHA was detected in 44% (31/70) of the patients. Preformed class I AHA was associated with an increased occurrence of grade 1-4 acute graft-versus host disease (p<0.05). The presence of anti- major-histocompatibility-complex class I-related chain A antigens (MICA) antibodies was significantly associated with a reduced platelet recovery after transplantation (p<0.05). AHA of class II with the strength of antibody titer measured as the mean fluorescence intensity above 2000 was associated with reduced event-free survival (p<0.05). A reduction of high titer of AHA and anti-MICA antibodies might have to be considered before cord blood transplantation in pediatric patients for better outcomes.

MeSH terms

  • Adolescent
  • Autoantibodies / blood
  • Child
  • Child, Preschool
  • Cord Blood Stem Cell Transplantation*
  • Disease-Free Survival
  • Female
  • Graft vs Host Disease / blood
  • Graft vs Host Disease / immunology*
  • HLA-A Antigens / immunology*
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Infant
  • Kaplan-Meier Estimate
  • Leukemia, Myeloid, Acute / immunology
  • Leukemia, Myeloid, Acute / mortality
  • Leukemia, Myeloid, Acute / therapy*
  • Male
  • Myelodysplastic Syndromes / immunology
  • Myelodysplastic Syndromes / mortality
  • Myelodysplastic Syndromes / therapy*
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult


  • Autoantibodies
  • HLA-A Antigens

Grants and funding

The authors have no support or funding to report.