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Successful allogeneic hematopoietic stem cell transplantation in a patient with type I CD36 deficiency: a case study and literature review

  • Case Report
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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.

Case report

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.

Discussion

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.

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Data availability

The authors declare that data supporting the findings of this study are fully described within the manuscript.

Abbreviations

AML:

Acute myeloid leukemia

CCI:

Corrected count increment

DSA:

Donor-specific anti-HLA antibodies

FNAIT:

Fetal-neonatal alloimmune thrombocytopenia

GVHD:

Graft-versus-host disease

HSCT:

Hematopoietic stem cell transplantation

PBSCT:

Peripheral blood stem cell transplantation

PT:

Platelet transfusion

PTR:

Platelet transfusion refractoriness

TRALI:

Transfusion-related acute lung injury

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Acknowledgements

We would like to express our sincere gratitude to Dr. Takuo Ito from the National Hospital Organization Kure Medical Center and Chugoku Cancer Center for providing crucial clinical information on the patient, and to Dr. Katsushi Tajima from the Yamagata Prefectural Central Hospital for offering invaluable feedback on this manuscript.

Funding

No funding was secured for this study.

Author information

Author notes

  1. Shuhei Okuyama

    Present address: Department of Hematology, Yamagata Prefectural Central Hospital, 1800 Aoyagi, Yamagata-Shi, Yamagata, 990-2292, Japan

Authors and Affiliations

  1. Department of Hematology, Nagano Red Cross Hospital, Nagano, Japan

    Shuhei Okuyama, Masahiko Sumi, Ryuto Ishikawa, Tsutomu Shishido, Daisuke Koyama, Toshimitsu Ueki & Hikaru Kobayashi

  2. Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan

    Daisuke Takahashi

  3. Laboratory Department, Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Tokyo, Japan

    Hironori Kobayashi & Nelson Hirokazu Tsuno

Authors
  1. Shuhei Okuyama
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  2. Masahiko Sumi
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Correspondence to Shuhei Okuyama.

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Okuyama, S., Sumi, M., Ishikawa, R. et al. Successful allogeneic hematopoietic stem cell transplantation in a patient with type I CD36 deficiency: a case study and literature review. Int J Hematol 118, 656–660 (2023). https://doi.org/10.1007/s12185-023-03637-4

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  • DOI: https://doi.org/10.1007/s12185-023-03637-4

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