Two Occurrences of Leukemia Relapse Due to Mismatched HLA Loss After Haploidentical Stem Cell Transplantation From Different Family Donors With KIR Ligand Mismatch

J Pediatr Hematol Oncol. 2020 Mar;42(2):e104-e106. doi: 10.1097/MPH.0000000000001443.

Abstract

Mismatched HLA loss is a cause of leukemia relapse after HLA-haploidentical stem cell transplantation (haplo-SCT). We report a patient with a history of 2 occurrences of leukemia relapse due to mismatched HLA loss after haplo-SCT. He received haplo-SCT from his father but showed leukemia relapse with loss of the maternal HLA haplotype. He then underwent haplo-SCT from his mother, and developed relapse with loss of the paternal HLA haplotype. Both donors had killer cell immunoglobulin-like receptor-ligand mismatch but alloreactive natural killer cells could not prevent relapse. Second haplo-SCT should be conducted carefully for patients with relapse due to mismatched HLA loss.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Female
  • Graft vs Leukemia Effect / immunology
  • HLA Antigens / immunology*
  • Histocompatibility / immunology*
  • Humans
  • Killer Cells, Natural / immunology*
  • Male
  • Neoplasm Recurrence, Local / diagnosis*
  • Neoplasm Recurrence, Local / etiology
  • Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / immunology
  • Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / pathology
  • Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Receptors, KIR / immunology*
  • Self Tolerance / immunology
  • Stem Cell Transplantation / adverse effects*
  • Transplantation Conditioning
  • Transplantation, Homologous
  • Treatment Outcome

Substances

  • HLA Antigens
  • Receptors, KIR