The NMDP and CIBMTR provided guidelines for the use of anti-HLA antibodies in unrelated-donors hematopoietic stem cell transplantation (HSCT). However, a deeper understanding of other potentially useful biomarkers for predicting clinical outcomes in HLA-A, B, C, DRB1, DQB1, DQA1(12/12) matched unrelated-donors of HSCT is needed to further improve clinical outcomes. We tested HLA genotyping for 123 pairs of patients and donors. Anti-HLA antibodies using the Luminex method was applied to 123, 117 and 106 serum samples collected before and 1 month and 3 months after transplantation. The presences of anti-HLA antibodies at the 3 time-points were 37.4% (46/123), 40.2% (47/117), and 22.6% (24/106). Patients with anti-HLA antibodies had delayed platelet recovery. The presence of anti-HLA antibodies and their dynamic changes after transplantation were associated with increased occurrence of grade II-IV acute graft-versus-host disease (aGVHD) and chronic GVHD, higher treatment-related mortality (TRM), and reduced overall survival (OS) and disease-free survival (DFS), especially in acute myeloid leukemia and myelodysplastic syndrome patients. Multivariate analysis showed that anti-HLA antibodies before transplantation was a risk factor for GVHD and OS. Our results suggest that dynamic changes of anti-HLA antibodies predicted for negative outcome of HSCT. Routine monitoring for anti-HLA antibody dynamics should be conducted before and after HSCT.

CITATION INFORMATION: He J, Pan Z, Yuan X, Li Y, Wu X, Zhu W, Bao X, Zhao Q. Dynamic Detection of Anti-HLA Antibodies Can Predict aGVHD and OS in HLA-12/12 Matched Unrelated-Donor Allo-HSCT for Hematological Malignancies. Am J Transplant. 2016;16 (suppl 3).

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