Ciftciler Rafiye, Goker Hakan, Buyukasık Yahya, Karaagac Tulay, Aksu Salih, Tekin Fatma, Demiroglu Haluk
Hacettepe University, Faculty of Medicine, Department of Hematology, Turkey.
Hacettepe University, Faculty of Medicine, Department of Hematology, Turkey.
Transfus Apher Sci. 2020 Feb;59(1):102597. doi: 10.1016/j.transci.2019.06.024. Epub 2019 Jul 10.
ABO and Rh compatibility are not required between the donor and recipient for allogeneic hematopoietic stem cell transplantation (alloHSCT). Although ABO incompatibility is not considered a contraindication in alloHSCT, its clinical outcomes are still doubtful. In this study, we analyzed the neutrophil and platelet recovery, graft versus host disease (GVHD), relapse rate, mortality rate, non-relapse mortality and survival in patients who underwent alloHSCT.
Two hundred and sixty four patients with hematological malignant diseases, aplastic anemia and inborn errors of metabolism or the immune system that received an alloHSCT in our HSC transplant center between the years of 2001 and 2018 were evaluated.
Indications for alloHSCT included both hematological malignancies (n = 233), aplastic anemia (n = 25) and benign conditions (n = 6). Of these donor recipient pairs, there were 189 (71.6%) matches, 36 (13.6%) major, 29 (11%) minor and 10 (3.8%) bidirectional ABO mismatches. The seventy-four (41.6%) of the ABO match and 27 (38.6%) of the ABO mismatch patients developed GvHD. The 5-year overall survival (OS) was ABO match group and ABO mismatch group were 65% and 73%, respectively (p = 0.36). The 5-year diasease free survival (DFS) for ABO match group and ABO mismatch group were 60% and 69%, respectively (p = 0.17).
In conclusion, this study showed that ABO mismatch did not seem to have a significant effect on major outcomes after alloHSCT, such as developing GVHD, relapse rate, mortality rate, DFS and OS. ABO incompatibility did not lead to delayed platelet and neutrophil engraftment after alloHSCT.
异基因造血干细胞移植（alloHSCT）中供体与受体之间不需要ABO和Rh血型相合。虽然ABO血型不合在alloHSCT中不被视为禁忌证，但其临床结局仍存在疑问。在本研究中，我们分析了接受alloHSCT患者的中性粒细胞和血小板恢复情况、移植物抗宿主病（GVHD）、复发率、死亡率、非复发死亡率和生存率。
评估了2001年至2018年间在我们的造血干细胞移植中心接受alloHSCT的264例血液系统恶性疾病、再生障碍性贫血以及代谢或免疫系统先天性疾病患者。
alloHSCT的适应证包括血液系统恶性肿瘤（n = 233）、再生障碍性贫血（n = 25）和良性疾病（n = 6）。在这些供受体对中，有189对（71.6%）匹配，36对（13.6%）主要ABO血型不合，29对（11%）次要ABO血型不合，10对（3.8%）双向ABO血型不合。ABO血型匹配患者中有74例（41.6%）发生了GVHD，ABO血型不合患者中有27例（38.6%）发生了GVHD。ABO血型匹配组和ABO血型不合组的5年总生存率（OS）分别为65%和73%（p = 0.36）。ABO血型匹配组和ABO血型不合组的5年无病生存率（DFS）分别为60%和69%（p = 0.17）。
总之本研究表明，ABO血型不合似乎对alloHSCT后的主要结局，如发生GVHD、复发率、死亡率、DFS和OS没有显著影响。ABO血型不合在alloHSCT后不会导致血小板和中性粒细胞植入延迟。
