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Exploring Differential Antibody Response to Bortezomib in Heart Transplantation.

K. Ghafourian, R. Hod-Dvorai, S. McCabe, N. Cool, M. Fine, M. Ackerman, J. Rich, J. Wilcox, E. Vorovich, A. Anderson, A. Tambur.

Northwestern University, Chicago, IL

Meeting: 2017 American Transplant Congress

Abstract number: C105

Keywords: Antibodies, Heart transplant patients, Sensitization

Session Information

Session Name: Poster Session C: Hearts and VADS: All Topics

Session Type: Poster Session

Date: Monday, May 1, 2017

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Hall D1

Twelve heart transplant candidates (2013-2016) received Bortezomib (BTZ) for desensitization. Differential antibody (Ab) response was observed. BTZ cycles consisted of 4 injections of 1.3 mg/m2; each preceded by 2 days of plasmapheresis (PP). BTZ dose was adjusted for side effects. Patients received pooled cryoprecipitate (Cryo) if Fibrinogen levels < 100 mg/dl before PP. Antibody load was defined by titers and significant Ab response was defined by the log2-difference of ≥2 in the average antibody titer. Sensitizing events during and within 3 months prior to therapy were identified. All 3 paradoxical responders and 1 non-responder received Cryo during the treatment. Titer or class of the antibody, the dose of BTZ, presence of VAD and other potentially sensitizing events did not appear to be associated with the response to treatment. Receiving pooled cryoprecipitate during desensitization treatment with BTZ may be associated with paradoxical Ab response to the treatment.

Subject/Gender BTZ (mg/m2) PRBC Vaccine Infection Cryo Highest Ab titer (PRA I, II) Ab log2 difference
1/M 5.7 + + + − 128 (47,96) (↓) 5.2
2/F 5.2 − + − − 512 (96,77) (↓) 4.2
3/F 9 + − + − 32 (100,31) (↓) 3.3
4/F 9.3 − + − − 64 (100,4) (↓) 2.8
5/F 10.4 − − − − >1024 (↓) 2.3
6/F 10 − + − − 512 (100,100) ([harr]) 1.3
7/F 4.4 − − − − 32 (81,28) ([harr]) 0.3
8/M 9.6 − − − + >1024 (0,84) ([harr]) 1
9/F 1.2 − + + − 32 (97,100) ([harr]) 0.7
10/M 7.3 − + − + 512 (99,0) (↑) 2.4
11/M 9.6 − + − + 1024 (100,22) (↑) 3.7
12/M 8.2 − + − + 8 (34,90) (↑) 4.9

CITATION INFORMATION: Ghafourian K, Hod-Dvorai R, McCabe S, Cool N, Fine M, Ackerman M, Rich J, Wilcox J, Vorovich E, Anderson A, Tambur A. Exploring Differential Antibody Response to Bortezomib in Heart Transplantation. Am J Transplant. 2017;17 (suppl 3).

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To cite this abstract in AMA style:

Ghafourian K, Hod-Dvorai R, McCabe S, Cool N, Fine M, Ackerman M, Rich J, Wilcox J, Vorovich E, Anderson A, Tambur A. Exploring Differential Antibody Response to Bortezomib in Heart Transplantation. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/exploring-differential-antibody-response-to-bortezomib-in-heart-transplantation/. Accessed May 12, 2025.

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