Selection of blood products to reduce immunization before HLA-mismatched allogeneic transplantation (SFGM-TC)

The increase of HLA-mismatched allogeneic stem cell transplantation, due to the use of post-transplant high-dose cyclophosphamide, has highlighted the detrimental impact of anti-HLA antibodies in the recipient, especially those directed against the donor (donor specific antibodies [DSA]), on transplant success. Blood products transfusions, in particular platelets, are a source of immunisation against donor HLA antigens and patients candidates to HLA-mismatched transplantation are at risk of developing DSA because of the elevated transfusion need. This Atelier gathers Immunogenetics and Transfusion Medicine experts to deal with the prevention of anti-HLA immunisation of patients waiting to HLA-mismatched transplantation, through the appropriate selection of blood products thus avoiding the appearance of DSA and optimising the engraftment rate.

Published by Bulletin du cancer, 2026. The guideline itself is at the source linked here.

doi.org/10.1016/j.bulcan.2025.03.016