Impact of ABO incompatibility on outcome after allogeneic peripheral blood stem cell transplantation

Abstract

Summary:Few studies have addressed the incidence of graft-versushost disease (GVHD) or survival after ABO-incompatible allogeneic peripheral blood stem cell transplantation (PBSCT). We analyzed the clinical outcome of ABO incompatibility after allogeneic PBSCT. A total of 89 consecutive adult patients with hematological diseases including 49 ABO-identical, 20 major, 15 minor, and five bidirectional ABO-incompatible transplants were enrolled from four medical centers in Korea. No significant difference in engraftment times, graft failure, or transfusion requirements between groups was noted. A clinical diagnosis of severe immune hemolysis or pure red cell aplasia was not made for any patient after transplantation. The incidence of acute or chronic GVHD did not statistically differ between groups. With a median followup duration of 13 months (range, 0.5-61 months), the 3-year overall survival estimates for the ABO-identical, major/bidirectional, and minor group were 44.6.079.0, 43.1711.6, and 43.8713.5%, respectively (P ¼ 0.8652), while the 3-year disease-free survival estimates were 33.877.6, 39.9711.4, and 45.7713.1%, respectively (P ¼ 0.8546). We observed that time to neutrophil, platelet, and red blood cell engraftment, transfusion requirements, incidence of acute or chronic GVHD, relapse, and survival were not influenced by ABO incompatibility after allogeneic PBSCT from HLAmatched sibling donors. Bone Marrow Transplantation (2005) 35, 489-495.

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

“…We found no significant effect of ABO mismatch on time to neutrophil and PLT engraftment, with a similar median engraftment time to previous HSCT studies. 26,29,42 Our study thus supports the view that the ABO blood group barrier should not be considered prohibitive to transplant.…”

“…21 The impact of ABO mismatch on transplant outcomes is variable, with a number of small and heterogeneous studies in the literature. 4,8,[22][23][24][25][26][27][28][29] Of the larger studies, a French registry study of 1108 RIC HSCT patients reported that MN ABO incompatibility was associated with reduced OS. 30 In the RIC subgroup of the largest registry study to date, Kimura et al 2 reported increased transplantrelated mortality (TRM) for MN, MJ and BD ABO-mismatched patients.…”

Red blood cell-incompatible allogeneic hematopoietic progenitor cell transplantation

“…Numerous reports of the effect (or lack thereof) of transplantation using HPC from ABO-disparate donors have been published (Tables 3a and b), including large registry studies; 2,[7][8][9] studies limited to PBPCs, [10][11][12] BM 1,2,7,9,[13][14][15][16][17][18][19][20] or cord blood sources of HPC; 21 reducedintensity conditioning regimens; 8,10,11,22,23 T-cell-depleted grafts; 17,19 and cohort studies from single or limited number of institutions. [24][25][26][27][28][29][30][31][32][33] Four large registry studies of HPC recipients including two studies of unrelated donor transplantation showed inconsistent results with some deleterious effect on engraftment, GvHD or survival being observed in some patient groups but not in others (Table 3a).…”

The number of infused CD34+ cells does not influence the incidence of GVHD or the outcome of allogeneic PBSC transplantation, using reduced-intensity conditioning and antithymocyte globulin

“…All other patients were classified as high-risk patients. 15,16 Statistical analysis The primary endpoint of this retrospective study was to analyze the correlation between the number of CD34 þ cells infused with the graft and the actuarial probability to develop aGVHD or cGVHD. The secondary endpoint was to analyze the correlation between the number of CD34 þ cells infused and OS, non-relapse mortality (NRM) and relapse.…”