Extensive reduction of anti-human leukocyte antigen antibodies after chemotherapy including blinatumomab for B-cell acute lymphoblastic leukemia

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  • 抗HLA抗体がblinatumomabを含む化学療法後に大幅に減少したB細胞性急性リンパ性白血病
  • コウHLA コウタイ ガ blinatumomab オ フクム カガク リョウホウ ゴ ニ オオハバ ニ ゲンショウ シタ Bサイボウ セイキュウセイ リンパセイ ハッケツビョウ

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Abstract

<p>A 66-year-old man with fever was diagnosed with B-cell acute lymphoblastic leukemia. He failed to achieve complete remission after initial hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (Hyper-CVAD) therapy and was referred to our hospital to undergo allogeneic stem cell transplantation. Bone marrow aspiration showed 97.5% lymphoblasts positive for CD19. Blood tests revealed the presence of broad antihuman leukocyte antigen (HLA) antibodies. After blinatumomab therapy, bone marrow aspiration showed 19.6% blasts. Furthermore, after additional mini-mitoxantrone, etoposide, and cytarabine (mini MEC) therapy, the patient achieved complete remission. Interestingly, after blinatumomab therapy, the blood tests revealed that the titers of anti-HLA antibodies had decreased, and cord blood transplantation was performed in complete remission. This case report revealed that chemotherapy including blinatumomab, which targets CD19-positive cells, has the potential to decrease antibody-producing cells, thus leading to a dramatic reduction of anti-HLA antibodies.</p>

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 63 (6), 550-554, 2022

    The Japanese Society of Hematology

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