ABO-incompatible bone marrow transplantation: a GITMO survey of current practice in Italy and comparison with the literature

Raimondi, Roberto; Soli, M; Lamparelli, Teresa; Bacigalupo, Andrea; Arcese, William; Belloni, M; Rodeghiero, Francesco

doi:10.1038/sj.bmt.1704579

Cited by 33 publications

(28 citation statements)

References 72 publications

(87 reference statements)

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“…As a result, a variety of approaches to ABO mismatch have been developed in selected patient groups, for example graft processing by red cell depletion or recipient isohaemagglutinin reduction by plasma exchange. 39,40 In the context of RIC HSCT, our study adds to a body of work to suggest that ABO mismatch has no significant impact on survival, TRM or relapse, irrespective of stem cell source (PBSC and marrow). 1,3,22,[43][44][45] In addition, a recent study by Romee et al 41 has shown no effect from ABO mismatch in umbilical cord HSCT.…”

Section: Discussionmentioning

confidence: 87%

Impact of ABO blood group mismatch in alemtuzumab-based reduced-intensity conditioned haematopoietic SCT

Brierley

Littlewood

Peniket

et al. 2015

Bone Marrow Transplant

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The impact of ABO incompatibility on clinical outcomes following haematopoietic SCT (HSCT) remains controversial. This retrospective study assessed the effect of ABO mismatch on transplant outcomes and transfusion requirements in 594 patients undergoing reduced-intensity conditioned (RIC) HSCT with alemtuzumab in three UK transplant centres. We found no significant effects of minor, major or bidirectional ABO mismatch on overall survival, relapse-free survival, nonrelapse mortality or relapse incidence. Although the rate of acute GVHD was unaffected by ABO mismatch, the incidence of extensive chronic GVHD was higher in patients with minor and major mismatch compared with those who were ABO matched (hazard ratio (HR) 1.74, P = 0.032 for minor, HR 1.69 P = 0.0036 for major mismatch). Red cell and platelet transfusion requirements in the first 100 days post transplant did not differ by ABO mismatch. In this large UK series, ABO mismatch in RIC HSCT has no clinically significant effect on survival outcomes but appears to modify susceptibility to extensive chronic GVHD.Bone Marrow Transplantation (2015) 50, 931-938;

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Section: Discussionmentioning

confidence: 87%

Impact of ABO blood group mismatch in alemtuzumab-based reduced-intensity conditioned haematopoietic SCT

Brierley

Littlewood

Peniket

et al. 2015

Bone Marrow Transplant

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“…18 This strategy, however, involves additional manipulation of the marrow product and may be associated with significant total nucleated cell loss. 2 This may be of particular concern if the progenitor cell content of the graft is low, potentially leading to poorer transplant outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…A survey of Gruppo Italiano Trapianto di Midollo Osseo centres found a high degree of heterogeneity in the methods used to address ABO-incompatible BMT. 18 In situations of major ABO incompatibility, 82.3% of centres always removed red cells from the graft, whereas 17.6% of centres decided whether red cell depletion was required based on the level of isohemagglutinin titre in the recipient. The method of red cell depletion was centre specific.…”

Section: Discussionmentioning

confidence: 99%

“…An alternative approach is to reduce the recipient's isohemagglutinin titre through plasma exchange, replacing with AB plasma or albumin; column immunoadsorption; or in vivo immunoadsorption using donor ABO-incompatible red cells. [15][16][17][18] There is no consensus on the best method of managing ABOincompatible BMT. 18 The most commonly used strategy is red cell depletion.…”

Section: Introductionmentioning

confidence: 99%

“…[15][16][17][18] There is no consensus on the best method of managing ABOincompatible BMT. 18 The most commonly used strategy is red cell depletion. Herein, we report on the safety of recipient plasma exchange without graft manipulation, for the management of ABO-incompatible BMT at a single institution.…”

Section: Introductionmentioning

confidence: 99%

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Major ABO-incompatible BMT: isohemagglutinin reduction with plasma exchange is safe and avoids graft manipulation

Sheppard

Tay

Bryant

et al. 2013

Bone Marrow Transplant

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The impact of donor-recipient ABO incompatibility on long-term BMT outcomes remains controversial. A common strategy is to deplete the donor marrow of red cells, although this variably reduces the number of CD34 þ cells. This 10-year retrospective study assessed the impact of recipient plasma exchange in major ABO-incompatible allogeneic BMT on outcomes and survival. Target Ab titres werep1:4 for anti-A andp1:8 for anti-B. Patients with higher titres underwent plasma exchange before marrow infusion. Of 133 patients who underwent allogeneic BMT, 34 had a major ABO-incompatible donor. The median number of exchanges was 2 (range 1-4). There were no acute haemolytic transfusion reactions. Engraftment times, transfusion requirements and acute and chronic GVHD were no different from those of patients with an ABO-identical donor. Treatment-related mortality at 100 days was 21% in the group with a major ABO-incompatible donor and 17% in the group with an identical donor (P ¼ 0.8). Plasma exchange of the recipient is a safe method of managing donor-recipient major ABO incompatibility before BMT without the risk of haematopoietic progenitor cell loss associated with red cell depletion of the graft.Bone Marrow Transplantation (2013) 48, 953-957;

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Infusion hemolysis after pediatric major ABO‐mismatched bone marrow transplant: Comparison of two red blood cell depletion techniques

Nickel

Qayed

Worthington-White

et al. 2017

Pediatric Blood & Cancer

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ABO-incompatible bone marrow transplantation: a GITMO survey of current practice in Italy and comparison with the literature

Cited by 33 publications

References 72 publications

Impact of ABO blood group mismatch in alemtuzumab-based reduced-intensity conditioned haematopoietic SCT

Impact of ABO blood group mismatch in alemtuzumab-based reduced-intensity conditioned haematopoietic SCT

Major ABO-incompatible BMT: isohemagglutinin reduction with plasma exchange is safe and avoids graft manipulation

Infusion hemolysis after pediatric major ABO‐mismatched bone marrow transplant: Comparison of two red blood cell depletion techniques

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