Abstract:
BACKGROUND:Reconstitution of hematopoiesis after hematopoietic stem cell transplantation (HSCT) occurs through a reservoir of donor CD34+ HSC. CD34+/VEGFR-2+ is a primitive, quiescent subpopulation of HSC known to generate hematopoietic or endothelial progeny in vitro and in vivo. We hypothesized that donor-specific antibodies to the CD34+/VEGFR-2+ stem cells may be associated with rejection after HSCT. METHODS:We studied 30 patients without and 11 with rejections after HSCT and 20 nontransplanted healthy individuals. Ninety-three sera taken pre and posttransplantation from patients receiving HSCT were studied for the presence of donor CD34+/VEGFR-2+ cell-specific antibodies. RESULTS:We provide evidence that significantly higher numbers of patients with rejections 9/11 (81%), whereas 1/30 (3%) (P=0.001) without rejections had antibodies against donor CD34+/VEGFR-2+ cells, but not CD34-/VEGFR-2- cells. In eight transplantations, antibodies against donor CD34+/VEGFR-2+ cells were detected already before transplantation. Purified IgG fractions from patients with rejections but not controls significantly decreased the ability of these cells to form hematopoietic and endothelial colonies. In multivariate analysis, antibodies against CD34+/VEGFR-2+ cells proved to be the most significant risk factor for rejection. CONCLUSIONS:These novel findings document a high rate of rejections in patients with donor-specific antibodies to CD34+/VEGFR-2+ HSC. These antibodies may significantly and commonly contribute to HSCT rejections.
journal_name
Transplantationjournal_title
Transplantationauthors
Nordlander A,Mattsson J,Sundberg B,Sumitran-Holgersson Sdoi
10.1097/TP.0b013e3181820333subject
Has Abstractpub_date
2008-09-15 00:00:00pages
686-96issue
5eissn
0041-1337issn
1534-6080pii
00007890-200809150-00012journal_volume
86pub_type
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