Frontiers in immunology · 2026
Case Report: Allogeneic hematopoietic stem cell transplantation in a patient with triple-allele expression at both HLA-B and HLA-C loci.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Fujita Yoshiyuki, Yoshihara Kyoko, Takahashi Daisuke, Tanaka Hidenori, Kino Yusuke, Yamagata Fuyuki, Samori Mami, Takahashi Saki, Yoshihara Satoshi
Аннотация
BACKGROUND: Human leukocyte antigen (HLA) matching is critical for donor selection in allogeneic hematopoietic stem cell transplantation (allo-HSCT). Each HLA locus is normally biallelic; however, exceptionally rare cases with more than two alleles at a single locus have been reported.
CASE PRESENTATION: We describe a 17-year-old male with mixed phenotype acute leukemia (T/myeloid) who was found to carry three alleles at both the HLA-B and HLA-C loci during pre-transplant evaluation. Family-based HLA typing revealed that the additional alleles were inherited as part of a single maternal haplotype shared by multiple siblings. Flow cytometric analysis using antisera with known HLA specificity demonstrated that all three HLA-B and HLA-C alleles were expressed on the cell surface. Because this unusual immunogenetic configuration precluded the identification of an unrelated donor, a sibling donor sharing the same triple-allele haplotype was selected despite a single HLA-A mismatch. Allo-HSCT was successfully performed, with manageable graft-versus-host disease.
CONCLUSION: This case highlights an extremely rare immunogenetic configuration in which triple-allele expression at two HLA class I loci directly influenced donor selection for allo-HSCT. Comprehensive interpretation of HLA typing results, including family analysis and protein-level expression, is essential when such atypical findings are encountered.
CASE PRESENTATION: We describe a 17-year-old male with mixed phenotype acute leukemia (T/myeloid) who was found to carry three alleles at both the HLA-B and HLA-C loci during pre-transplant evaluation. Family-based HLA typing revealed that the additional alleles were inherited as part of a single maternal haplotype shared by multiple siblings. Flow cytometric analysis using antisera with known HLA specificity demonstrated that all three HLA-B and HLA-C alleles were expressed on the cell surface. Because this unusual immunogenetic configuration precluded the identification of an unrelated donor, a sibling donor sharing the same triple-allele haplotype was selected despite a single HLA-A mismatch. Allo-HSCT was successfully performed, with manageable graft-versus-host disease.
CONCLUSION: This case highlights an extremely rare immunogenetic configuration in which triple-allele expression at two HLA class I loci directly influenced donor selection for allo-HSCT. Comprehensive interpretation of HLA typing results, including family analysis and protein-level expression, is essential when such atypical findings are encountered.