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Vol. 25, Art. 18 (pp. 319-332)    |    2024       

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Sensitization to HLA antigens in patients with multiple myeloma

Kuzmich E.V., Pavlova I.E., Bessmeltsev S.S.

Federal state budgetary institution "Russian Research Institute of Hematology and Transfusiology of the Federal Medical and Biological Agency"

Brief summary

Detection and subsequent monitoring of anti-HLA antibodies may be important for multiple myeloma (MM) patients for several reasons. In the early post-transplantation period after autologous hematopoietic stem cell transplantation, MM patients in some cases require transfusions of blood components, the effectiveness of which depends, among other things, on the presence of pre-existing anti-HLA antibodies in the patient. Secondly, almost half of patients with newly diagnosed MM are diagnosed with renal failure, among which 20% suffer from severe renal failure, and 10% of patients need dialysis, so some patients may be candidates for kidney transplantation. The aim of the study was to determine the frequency of anti-HLA antibodies in patients with multiple myeloma. Materials and methods. Forty-five patients diagnosed with MM (21 males and 24 females) were included in the study. The median age of the patients was 55 years. The method of the study was multiplex fluorescent immunoassay using Luminex 200 platform. A positive result was when MFI > 500. Results. Antibodies to HLA-antigens were detected in 3 patients, which amounted to 12,5% of the examined women or 6,7% of the total number of patients. Allosensitizing events were established only in women: 7 persons (29,2%) had the blood component transfusions; 22 persons (91,7%) had pregnancies. Myeloma nephropathy was found in 6 persons (13,3% of patients), of whom 5 were men and 1 woman. HLA class I antibodies were determined in two patients, HLA class II antibodies  in one patient. According to anamnesis data, the sensitizing event in all cases was pregnancy. Conclusion. Thus, the frequency of HLA antibodies in patients with multiple myeloma was 6,7%. No significant differences in the frequency of HLA antibodies class I and class II were found


Key words

allosensitizing event; anti-HLA antibodies; autologous hematopoietic stem cell transplantation; multiple myeloma

Reference list

1. Rodey G. HLA beyond tears: Introduction to human histocompatibility. Colorado: De Novo Inc.; 2000: 212-214.


2. Lowe D., Briggs D., Daga S. et al. HLA antibodies in an untransfused male possibly generated by exposure to blood from bare knuckle cage fighting. Tissue Antigens. 2012; 79(6): 496-497.


3. Cano P., Patel H., Cao K. Anti-HLA-class-I antibodies and platelet transfusion refractoriness. Human Immunol. 2013; 74(S1): 169-170.


4. Delaflor-Weiss E., Mintz P.D. The evaluation and management of platelet refractoriness and alloimmunization. Transfus. Med. Rev. 2002; 14(2): 180-196.


5. Bessmelcev S.S. Mnojestvennaya mieloma: diagnostika i terapiya (chast 1). Vestnik gematologii. 2022; 18(2): 4-26.


6. Wirk B. Renal failure in multiple myeloma: a medical emergency. Bone Marrow Transplant. 2011; 46(6): 771-783. https://doi.org/10.1038/bmt.2011.8


7. Borovkova N.V., Pinchyk A.V., Shmarina N.V. i dr. Vibor immynosypressivnoi terapii v zavisimosti ot yrovnya antitel k HLA pri transplantacii pochki. Transplantologiya. 2018; 10(1): 35-41. https://doi.org/10.23873/2074-0506-2018-10-1-35-41


8. Bytina E.V., Zaiceva G.A. Diagnostika immynologicheskogo konflikta pri beremennosti. Rossiiskii vestnik akyshera-ginekologa. 2014; 3: 16-19.


9. Triulzi D.J., Kleinman S., Kakaiya R.M. et al. The Effect of Previous Pregnancy and Transfusion on HLA Alloimmunization in Blood Donors: Implications for a Transfusion Related Acute Lung Injury (TRALI) Risk Reduction Strategy. Transfusion. 2009; 49(9): 1825-1835. https://doi.org/10.1111/j.1537-2995.2009.02206.x


10. Balasubramaniam G.S., Morris M., Gupta A. et al. Allosensitization rate of male patients awaiting first kidney grafts after leuko-depleted blood transfusion. Transplantation. 2012; 93(4): 418-422. https://doi.org/10.1097/TP.0b013e3182419864


11. Theves F., Kheav D., Talbot A. et al. Impact of Daratumumab on Anti-HLA Antibodies Level in Patients with Multiple Myeloma, a Role in Transplantation? Clinics in Oncology. 2022; 7: article 1939. Available at: https://www.clinicsinoncology.com/open-access/impact-of-daratumumab-on-anti-hla-antibodiesnbsplevel-in-patients-9127.pdf


12. Heybeli C., Bentall A.J., Alexander M.P. et al. Kidney transplant outcomes of patients with multiple myeloma. Kidney International Reports. 2022; 7(4): 752-762. https://doi.org/10.1016/j.ekir.2022.01.003