Abstract：
BACKGROUND: CD36-deficient individuals may produce anti-CD36 antibodies through antigenic exposure to CD36, in situations including blood transfusions. Therefore, allogeneic hematopoietic stem cell transplantation (HSCT) from CD36-positive donors to CD36-negative patients remains a challenge.
METHODS: A 64-year-old man with acute myeloid leukemia became refractory to platelet transfusions during chemotherapy. Anti-CD36 antibodies without anti-HLA antibodies were detected in serum, and the absence of CD36 expression on platelets and monocytes confirmed type I CD36 deficiency. The patient achieved complete remission, and received maintenance therapy with CD36-negative platelet transfusions. However, he relapsed soon afterward, and thus underwent peripheral blood stem cell transplantation (PBSCT) from a CD36-positive unrelated donor. The anti-CD36 antibody titer had decreased before the transplant, and the PBSCT-course was uneventful. The patient has been well without any complications associated with CD36 status mismatch.
CONCLUSIONS: The few reports of allogeneic HSCT in patients with CD36 deficiency have suggested that anti-CD36 antibodies could be involved in several post-transplant complications, such as delayed platelet recovery, transfusion refractoriness, and transfusion-related acute lung injury. Our present case confirmed that stem cell transplantation from CD36-positive donors to negative patients is feasible, when it includes careful prior assessment of anti-CD36 antibody titers and interventions to attenuate them.
METHODS: A 64-year-old man with acute myeloid leukemia became refractory to platelet transfusions during chemotherapy. Anti-CD36 antibodies without anti-HLA antibodies were detected in serum, and the absence of CD36 expression on platelets and monocytes confirmed type I CD36 deficiency. The patient achieved complete remission, and received maintenance therapy with CD36-negative platelet transfusions. However, he relapsed soon afterward, and thus underwent peripheral blood stem cell transplantation (PBSCT) from a CD36-positive unrelated donor. The anti-CD36 antibody titer had decreased before the transplant, and the PBSCT-course was uneventful. The patient has been well without any complications associated with CD36 status mismatch.
CONCLUSIONS: The few reports of allogeneic HSCT in patients with CD36 deficiency have suggested that anti-CD36 antibodies could be involved in several post-transplant complications, such as delayed platelet recovery, transfusion refractoriness, and transfusion-related acute lung injury. Our present case confirmed that stem cell transplantation from CD36-positive donors to negative patients is feasible, when it includes careful prior assessment of anti-CD36 antibody titers and interventions to attenuate them.
摘要：
背景：在包括输血在内的情况下，CD36缺陷型个体可能通过抗原暴露于CD36而产生抗CD36抗体。因此,从CD36阳性供体到CD36阴性患者的异基因造血干细胞移植（HSCT）仍然是一个挑战。
方法：一名64岁的急性髓系白血病患者在化疗期间难以输注血小板。检测血清中不含抗HLA抗体的抗CD36抗体,血小板和单核细胞CD36表达缺失证实I型CD36缺乏。病人完全缓解,并接受CD36阴性血小板输注维持治疗。然而,他很快就复发了，因此接受了来自CD36阳性无关供体的外周血干细胞移植（PBSCT）。抗CD36抗体滴度在移植前有所下降,PBSCT课程顺利。患者没有任何与CD36状态不匹配相关的并发症。
结论：在CD36缺乏症患者中出现同种异体HSCT的少数报道表明，抗CD36抗体可能与几种移植后并发症有关，如血小板恢复延迟，输血难治性，与输血相关的急性肺损伤。我们目前的病例证实，从CD36阳性供体到阴性患者的干细胞移植是可行的，当它包括仔细事先评估抗CD36抗体滴度和干预以减弱它们时。
方法：一名64岁的急性髓系白血病患者在化疗期间难以输注血小板。检测血清中不含抗HLA抗体的抗CD36抗体,血小板和单核细胞CD36表达缺失证实I型CD36缺乏。病人完全缓解,并接受CD36阴性血小板输注维持治疗。然而,他很快就复发了，因此接受了来自CD36阳性无关供体的外周血干细胞移植（PBSCT）。抗CD36抗体滴度在移植前有所下降,PBSCT课程顺利。患者没有任何与CD36状态不匹配相关的并发症。
结论：在CD36缺乏症患者中出现同种异体HSCT的少数报道表明，抗CD36抗体可能与几种移植后并发症有关，如血小板恢复延迟，输血难治性，与输血相关的急性肺损伤。我们目前的病例证实，从CD36阳性供体到阴性患者的干细胞移植是可行的，当它包括仔细事先评估抗CD36抗体滴度和干预以减弱它们时。
