CD36 immunization in a patient undergoing hematopoietic stem cell transplantation

Area of Science:

• Immunology
• Hematology
• Transplantation

Background:

• Anti-CD36 antibodies can induce a platelet refractory state, complicating transfusions.
• Platelet refractoriness poses challenges for patients requiring transfusion support, particularly before procedures like hematopoietic stem cell transplantation (HSCT).

Observation:

• A 16-year-old female with sickle cell disease was found to have anti-CD36 antibodies during pre-transplantation screening.
• The patient and her HLA-identical sibling donor were both negative for CD36 platelet antigen typing.
• The patient's plasma showed compatibility with most apheresis platelets, suggesting they expressed the CD36 antigen.

Findings:

• Despite the presence of anti-CD36 antibodies, the patient received compatible platelet transfusions.
• The patient successfully underwent HSCT, indicating that anti-CD36 antibodies can be managed.

Implications:

• The presence of anti-CD36 antibodies should not automatically disqualify potential HSCT candidates.
• Careful pre-transplant screening and crossmatching can identify compatible platelet products for patients with alloantibodies.
• This case expands the understanding of managing platelet alloimmunization in the context of HSCT for sickle cell disease.