{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:05:51Z","timestamp":1777878351945,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Hematology"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>In haploidentical hematopoietic stem cell transplantation, preexisting donor-specific anti-HLA antibodies (DSAs) in recipients have been associated with graft rejection, poor graft function (PGF), and unfavorable clinical outcomes, with relatively well-established consensus strategies for its management. However, reports on the emergence of de novo DSAs after transplantation and the corresponding therapeutic approaches remain limited. Here, we describe a case of a 14-year-old patient with myelodysplastic syndrome who developed de novo DSAs as early as day 15 post-transplantation, with a peak mean fluorescence intensity of 12,280, which was associated with PGF. To reduce DSA levels, plasma exchange combined with intravenous immunoglobulin and rituximab was administered, followed by a series of interventions including mesenchymal stem cell infusion. These measures facilitated graft function recovery, controlled transplant-related complications, and ultimately led to successful engraftment.<\/jats:p>","DOI":"10.1177\/20406207261417496","type":"journal-article","created":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T15:41:53Z","timestamp":1770565313000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Early-onset de novo donor-specific anti-HLA antibodies may contribute to poor graft function following haploidentical transplantation for myelodysplastic syndrome: a rare case presentation"],"prefix":"10.1177","volume":"17","author":[{"given":"Xianbo","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"},{"name":"Zhejiang Provincial Clinical Research Center for Hematological Disorders, Hangzhou 310003, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianhui","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"},{"name":"Zhejiang Provincial Clinical Research Center for Hematological Disorders, Hangzhou 310003, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shasha","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"},{"name":"Zhejiang Provincial Clinical Research Center for Hematological Disorders, Hangzhou 310003, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"},{"name":"Zhejiang Provincial Clinical Research Center for Hematological Disorders, Hangzhou 310003, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8071-8175","authenticated-orcid":false,"given":"Chen","family":"Mei","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"},{"name":"Zhejiang Provincial Clinical Research Center for Hematological Disorders, Hangzhou 310003, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fengwei","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"},{"name":"Zhejiang Provincial Clinical Research Center for Hematological Disorders, Hangzhou 310003, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0874-7806","authenticated-orcid":false,"given":"Yanling","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"},{"name":"Zhejiang Provincial Clinical Research Center for Hematological Disorders, Hangzhou 310003, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 366 Wutong Road, Hangzhou, Zhejiang, China"},{"name":"Zhejiang Provincial Clinical Research Center for Hematological Disorders, Hangzhou 310003, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5603-4160","authenticated-orcid":false,"given":"Hongyan","family":"Tong","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 366 Wutong Road, Hangzhou, Zhejiang, China"},{"name":"Zhejiang Provincial Clinical Research Center for Hematological Disorders, Hangzhou 310003, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiejing","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 366 Wutong Road, Hangzhou, Zhejiang, China"},{"name":"Zhejiang Provincial Clinical Research Center for Hematological Disorders, Hangzhou 310003, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,2,8]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2025.101286"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.27597"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1165759"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.19046"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/head.12246"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-022-01613-1"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2025.0013"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2024.107617"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-021-01222-z"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2015.05.001"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2011.131"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13045-015-0182-9"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-06-362111"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gft362"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.916200"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.1047200"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2022.11.013"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtct.2023.05.014"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.humimm.2018.08.009"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/tan.15560"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15055"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12590"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2012.81"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13192"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-017-0062-8"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/tan.15300"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1106464"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.911174"}],"container-title":["Therapeutic Advances in Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20406207261417496","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/20406207261417496","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20406207261417496","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T23:18:12Z","timestamp":1777591092000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/20406207261417496"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":28,"alternative-id":["10.1177\/20406207261417496"],"URL":"https:\/\/doi.org\/10.1177\/20406207261417496","relation":{},"ISSN":["2040-6207","2040-6215"],"issn-type":[{"value":"2040-6207","type":"print"},{"value":"2040-6215","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]},"article-number":"20406207261417496"}}