Impact of Circulating Lymphoma Cells on HLA Typing Outcomes in Patients with Diffuse Large B-Cell Lymphoma: A Case Report.
Transplant Proc
; 56(4): 1026-1028, 2024 May.
Article
em En
| MEDLINE
| ID: mdl-38714370
ABSTRACT
BACKGROUND:
Recipient's high resolution HLA typing is required in allogeneic hematopoietic cell transplantation from unrelated donors, as well as for haploidentical family donors. For these purposes, Next-Generation Sequencing (NGS) methods are the gold standard.METHODS:
We present a case of a patient with an incorrect HLA typing result caused by the population of circulating lymphoma cells. The first HLA examination was performed from peripheral blood (PB) using NGS in the active phase of diffuse large B-cell lymphoma with bone marrow involvement.RESULTS:
Because of rare and inconclusive results, confirmed twice for the A* locus (A*0232N), real-time polymerase chain reaction (RT-PCR)was performed. With RT-PCR method, we obtained more expected results according to the population allele frequency in HLA-A locus (A*0201) but also in DQB1 (DQB1*0301, not as in NGS - DQB1*0310). For the final verification, we used swab material and we obtained unambiguous NGS result with expected, frequent HLA-A*0201 and DQB1*0301 alleles corresponding to the RT-PCR result from PB.CONCLUSIONS:
To conclude, we suspect that the discrepancies between NGS and RT-PCR results were caused by the presence of a significant amount of circulating lymphoma cells in the peripheral blood sample. Lymphomagenic mutations may involve the histocompatibility antigen coding region and affect HLA expressed on malignant cells. This finding may be relevant for the selection of test material in primary and confirmatory HLA testing in patients with active hematological malignancies because of the strong impact of incorrect HLA typing on the procedure of a donor selection.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Teste de Histocompatibilidade
/
Linfoma Difuso de Grandes Células B
Limite:
Female
/
Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article