Effects of ABO incompatibility in allogeneic hematopoietic stem cell transplantation

被引：13

作者：

Atilla, P. Ataca ^{[1
]}

Akkus, E. ^{[2
]}

Atilla, E. ^{[1
]}

Gokmen, N. ^{[3
]}

Bozdag, S. Civriz ^{[1
]}

Toprak, S. Kocak ^{[1
]}

Yuksel, M. Kurt ^{[1
]}

Ozcan, M. ^{[1
]}

Demirer, T. ^{[1
]}

Ilhan, O. ^{[1
]}

Beksac, M. ^{[1
]}

Akan, H. ^{[1
]}

Arslan, O. ^{[1
]}

Topcuoglu, P. ^{[1
]}

Gurman, G. ^{[1
]}

机构：

[1] Ankara Univ, Dept Hematol, Sch Med, TR-06590 Dikimevi Ankara, Turkey

[2] Ankara Univ, Dept Internal Med, Sch Med, Ankara, Turkey

[3] Istanbul Tech Univ, Dept Basic Sci, Istanbul, Turkey

来源：

TRANSFUSION CLINIQUE ET BIOLOGIQUE | 2020年 / 27卷 / 03期

关键词：

ABO mismatch; Allogeneic hematopoietic stem cell transplantation; Outcome; hemolysis; Graft versus host disease; BONE-MARROW; UNRELATED DONORS; RISK-FACTORS; IMPACT; MISMATCH; COMPATIBILITY; RECIPIENTS; APLASIA; BMT;

D O I：

10.1016/j.tracli.2020.06.008

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction. - The impact of ABO mismatch on outcomes following allo-HSCT remains controversial. In this study, our aim is to define the effect of ABO mismatch on post-transplant outcomes, engraftment kinetics and complications in a large cohort. Patients and methods. - We retrospectively identified 1000 patients who underwent allo-HSCT from either bone marrow or peripheral blood stem cells at our center between 1988 and 2016. P < 0.05 was considered statistically significant. Results. - Five hundred and ninety (59%) patient-donor pairs were ABO matched, 164 (16.4%) were ABO major mismatched (MM), 191 (19.1%) were ABO minor MM, and 55 (5.5%) were ABO bi-directionally MM. ABO matched pairs were more common in transplants from related donors (P < 0.001) and using bone marrow as a stem cell source (P < 0.001). In minor ABO MM transplantations, mild delayed hemolytic reaction occurred more frequently compared to major and bidirectional ABO MM transplantations (47% vs 35% and 18%, P < 0.001). Neutrophil engraftment was slightly delayed in ABO MM patient-donor pairs when compared ABO matched donor pairs according to median engraftment time in all group (167/410, 41% vs 204/590, 35%, P = 0.046). Pure red cell aplasia was diagnosed in 6 patients (1%). Higher risk of death was shown in ABO MM transplants compared to ABO matched transplants in overall survival (OS) analysis (HR:1.201, 95% CI:1.004-1.437, P = 0.045). The non-relapse mortality (P = 0.546) and cumulative incidences of acute graft versus host disease (aGVHD) and chronic (c) GVHD were comparable between ABO MM and ABO matched patient-donor pairs (for aGVHD, P = 0.235; for cGVHD, P= 0.137). Conclusion. - ABO MM transplants were associated with decreased OS and slightly delayed neutrophil engraftment. NRM and the risk of GVHD were not related to ABO incompatibility. (C) 2020 Societe francaise de transfusion sanguine (SFTS). Published by Elsevier Masson SAS. All rights reserved.

引用

页码：115 / 121

页数：7

共 29 条

[1] ABO COMPATIBILITY AND ACUTE GRAFT-VERSUS-HOST DISEASE FOLLOWING ALLOGENEIC BONE-MARROW TRANSPLANTATION [J].