ABO incompatibility in mismatched unrelated donor allogeneic hematopoietic cell transplantation for acute myeloid leukemia: A report from the acute leukemia working party of the EBMT

Abstract

ABO incompatibility is commonly observed in stem cell transplantation and its impact in this setting has been extensively investigated. HLA-mismatched unrelated donors (MMURD) are often used as an alternative stem cell source but are associated with increased transplant related complications. Whether ABO incompatibility affects outcome in MMURD transplantation for acute myeloid leukemia (AML) patients is unknown. We evaluated 1,013 AML patients who underwent MMURD transplantation between 2005 and 2014. Engraftment rates were comparable between ABO matched and mismatched patients, as were relapse incidence [34%; 95% confidence interval (CI), 28-39; for ABO matched vs. 36%; 95% CI, 32-40; for ABO mismatched; P 5 .32], and nonrelapse mortality (28%; 95% CI, 23-33; for ABO matched vs. 25%; 95% CI, 21-29; for ABO mismatched; P 5 .2). Three year survival was 40% for ABO matched and 43% for ABO mismatched patients (P 5 .35), Leukemia free survival rates were also comparable between groups (37%; 95% CI, 32-43; for ABO matched vs. 38%; 95% CI, 33-42; for ABO mismatched; P 5 .87).Incidence of grade II-IV acute graft versus host disease was marginally lower in patients with major ABO mismatching (Hazard ratio of 0.7, 95% CI, 0.5-1; P 5 .049]. ABO incompatibility probably has no significant clinical implications in MMURD transplantation.

Who is the best haploidentical donor for acquired severe aplastic anemia? Experience from a multicenter study

“…Ozkurt et al reported more frequent severe aGVHD among minor ABO-mismatched patients [32], but Kimura et al found a high incidence of severe aGVHD in both major and minor ABO mismatches [33]. There were also conflicting results that failed to find a difference in rates of aGVHD between minor ABO incompatibility and others [34–36]. No evidence of an association between the ABO mismatch and cGVHD or survival was observed in this study.…”

ABO Mismatch in Allogeneic Hematopoietic Stem Cell Transplant: Effect on Short- and Long-term Outcomes

“…Similarly, an analogous mechanism has been hypothesized to explain the mitigating effect of major ABO-I on severe aGVHD. 6 , 27 …”

ABO Blood Type Incompatibility Is Not a Risk Factor of Outcomes for Acute Myeloid Leukemia (AML) Patients After Unmanipulated Haplo-identical Peripheral Blood Hematopoietic Stem Cell Transplantation

“…Chang et al [23] retrospectively analyzed factors correlating with hematopoietic recovery in 133 pediatric patients (including AML patients) after unmanipulated HLA-mismatched/haplo-identical blood and marrow transplantation; their univariate analysis revealed ABO compatibility was not a risk factor of neutrophil engraftment and platelet engraftment. The study reported by Canaani et al [16] was a retrospective, multicenter study containing 837 AML patients receiving HLA haplo-identical bone marrow or G-CSF mobilized peripheral blood stem cell transplantation. In patients transplanted with bone marrow, minor ABO mismatch was associated with higher incidence of grade II–IV aGVHD and major ABO mismatch was associated with poor survival.…”