ABO blood group mismatched hematopoietic stem cell transplantation

Tekgündüz, Sibel Akpınar; Özbek, Namık

doi:10.1016/j.transci.2016.01.008

Cited by 12 publications

(9 citation statements)

References 53 publications

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“…For this reason, knowledge of the titer of incompatible isoagglutinins present in units of platelets stored in whole blood and plasma should be used to guide component selection to reduce the risk of hemolysis . This is particularly true for recipients of ABO‐incompatible solid organs (e.g., kidney) or stem cell transplants, as these patients are at risk for the development of graft injury or hemolysis as a consequence of exposure to incompatible isoagglutinins via transfusion . Further, comparison of the pre‐ and posttransplant isoagglutinin titers is a part of the therapeutic algorithm for patients who have received ABO‐incompatible transplants, as the prompt initiation of plasma exchange to diminish incompatible isoagglutinins can be critical for these patients …”

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confidence: 99%

“…exposure to incompatible isoagglutinins via transfusion. 5,6 Further, comparison of the pre-and posttransplant isoagglutinin titers is a part of the therapeutic algorithm for patients who have received ABO-incompatible transplants, as the prompt initiation of plasma exchange to diminish incompatible isoagglutinins can be critical for these patients. 7,8 The Johns Hopkins Hospital (JHH) is a high-volume academic transfusion service that supports both an active ABO-incompatible kidney organ transplantation program and a large allogeneic ABO-incompatible stem cell transplantation program.…”

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confidence: 99%

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Isohemagglutinin titering performed on an automated solid‐phase and hemagglutinin‐based analyzer is comparable to results obtained by manual gel testing

Lally¹,

Kruse²,

Smetana³

et al. 2020

Transfusion

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BACKGROUND Isohemagglutinins (anti‐A and anti‐B) mediate hemolytic transfusion reactions, antibody‐mediated rejection of solid‐organ transplants, and delayed engraftment after stem cell transplant. However, quantification of isohemagglutinins is often labor intensive and operator dependent, limiting availability and interfacility comparisons. We evaluated an automated, solid‐phase and agglutination‐based antibody titer platform versus manual gel testing. STUDY DESIGN AND METHODS Plasma samples were obtained from 54 randomly selected patients. Titers were determined by our laboratoryʼs standard assay (manual dilution followed by manual gel testing) and were compared to results obtained on a fully automated blood bank analyzer (Galileo NEO, Immucor). The analyzer determined immunoglobulin G (IgG) antibodies using solid‐phase and immunoglobulin M (IgM) antibodies by direct hemagglutination. RESULTS Isohemagglutinin titers obtained by manual gel versus the automated assay generally (>80%) agreed within one doubling dilution, and always (100%) agreed within two dilutions. Among O samples, the gel titer and the highest titer obtained with the automated assay (either IgG or IgM) were similar in paired, nonparametric analysis (p = 0.06 for anti‐A; p = 0.13 for anti‐B). Gel titers from group A and group B patients were slightly higher than the highest titer obtained using the automated assay (p = 0.04 for group A; p = 0.009 for group B), although these differences were within the accepted error of measurement. CONCLUSION Manual and automated methodologies yielded similar isohemagglutinin titers. Separate quantification of IgM and IgG isohemagglutinins via automated titration may yield additional insight into hemolysis, graft survival after ABO‐incompatible transplantation, and red blood cell engraftment after ABO‐incompatible stem cell transplant.

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confidence: 99%

mentioning

confidence: 99%

Isohemagglutinin titering performed on an automated solid‐phase and hemagglutinin‐based analyzer is comparable to results obtained by manual gel testing

Lally¹,

Kruse²,

Smetana³

et al. 2020

Transfusion

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“…However, ABO‐incompatible HSCTs are routinelyperformed, with the administration of the appropriate bloodtransfusion therapies 1,5,6 . There are also reports that ABO incompatibility can delay the engraftment of neutrophils and platelets (PLTs) 2,4,7–9 while others state that delayed engraftment of neutrophils and PLTs are not related to ABO incompatibility 2,10,11 . Since various donor sources including cord blood have been used in recent years, the influence of donor sources on ABO‐incompatible HSCT recovery may be of concern.…”

Section: Introductionmentioning

confidence: 99%

“…Since various donor sources including cord blood have been used in recent years, the influence of donor sources on ABO‐incompatible HSCT recovery may be of concern. In addition, research on erythropoiesis has shown that ABO incompatibility delays erythrocyte engraftment or presents a risk for developing pure red cell aplasia (PRCA) 2,4,6,8,11,12 . However, the specific types of ABO‐incompatible HSCTs that cause delayed erythrocyte engraftment are not yet fully understood.…”

Section: Introductionmentioning

confidence: 99%

Investigation of risk factors associated with erythrocyte engraftment after ABO‐incompatible hematopoietic stem cell transplantation

Yanagisawa

Nakazawa

Nishina

et al. 2021

Clinical Transplantation

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ABO‐incompatible hematopoietic stem cell transplantations (HSCTs) are widely practiced; however, the delay in erythrocyte engraftment can be problematic. While erythrocyte engraftment is usually indicated by an increase in reticulocyte levels without the need for erythrocyte transfusions, the disappearance of recipient‐derived anti‐A/B isoagglutinin and detection of donor‐derived A/B antigens can also be used as other parameters. We conducted a retrospective analysis of 68 ABO‐incompatible HSCTs, focusing on major and bidirectional mismatch. We analyzed known clinical risk factors associated with delayed erythrocyte engraftment using the three parameters (disappearance of anti‐A/B isoagglutinin in recipient, detection of donor‐derived A/B antigen, and reticulocyte levels >1%). Although the three parameters were well correlated, the results showed heterogeneity when analyzing the associated risk factors for delayed erythrocyte engraftment. In the analysis of all cases, the requirement for an HLA‐matched platelet transfusion was a common risk factor. Furthermore, erythrocyte engraftment was slower in adults than in children. In adults, cytomegalovirus antigenemia was a risk factor for two parameters; however, in children, underlying disease was a common risk factor for all parameters. There is a complex relationship between erythrocyte engraftment and various factors related to HSCTs. Our results suggest that greater accuracy is possible by using analysis methods other than the measurement of reticulocyte levels.

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“…Before transplantation, we can decrease antibody titers by plasma or whole blood exchange 8 . HSCT with major ABO incompatibility can be more complicated compared to peripheral blood stem cell (PBSC) since grafts from bone marrow contain high amount of red blood cells 9 .…”

Section: Introductionmentioning

confidence: 99%

ABO Blood Grouping Mismatch in Hematopoietic Stem Cell Transplantation and Clinical Guides

Shokrgozar

Tamaddon

2018

IJHOSCR

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Hematopoietic stem cell transplantation (HSCT) is a useful treatment. In contrast to solid organ transplantations, the use of ABO blood group mismatch is acceptable in HSCT. Immediate or late hemolytic reactions, pure red cell aplasia, delayed red blood cell recovery, and graft-versus -host disease are the results of this situation. This review shows the consequences of ABO-mismatched HSCT and its impacts on HSCT parameters, as well as providing clinical guides in this situation.

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ABO blood group mismatched hematopoietic stem cell transplantation

Cited by 12 publications

References 53 publications

Isohemagglutinin titering performed on an automated solid‐phase and hemagglutinin‐based analyzer is comparable to results obtained by manual gel testing

Isohemagglutinin titering performed on an automated solid‐phase and hemagglutinin‐based analyzer is comparable to results obtained by manual gel testing

Investigation of risk factors associated with erythrocyte engraftment after ABO‐incompatible hematopoietic stem cell transplantation

ABO Blood Grouping Mismatch in Hematopoietic Stem Cell Transplantation and Clinical Guides

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