Borhany Munira, Ali Muhammad Shujat, Ghias Zainab, Abid Madiha, Zafar Sidra, Shamsi Tahir
Department of Clinical Hematology and Bone Marrow Transplantation, National Institute of blood Diseases, Karachi, PAK.
Department of Clinical Hematology and Bone Marrow Transplantation, National Institute of Blood Diseases, Karachi, PAK.
Cureus. 2023 Sep 18;15(9):e45442. doi: 10.7759/cureus.45442. eCollection 2023 Sep.
Background and objective Allogeneic hematopoietic stem cell transplantation (alloHSCT) provides curative treatment for several hematological illnesses. In this study, we evaluated the impact of ABO compatibility and incompatibility on outcomes and complications related to hematopoietic stem cell transplantation (HSCT) performed for various hematological disorders at our center. Methodology This was a retrospective, single-center, cohort study in which patients were categorized according to the ABO match and mismatch status. The mismatch group was further subcategorized into major, minor, and bidirectional groups. Results A total of 117 patients underwent alloHSCT, out of which 82 (70.1%) were male and 35 (30%) were female. The median age of the patients was 9.5 years (range: 46 years). The most common indications for stem cell transplant were beta-thalassemia major (BTM; n=58, 49%) and aplastic anemia (AA; n=42, 35.8%). However, the outcomes in match and mismatch groups showed significant results for positive direct Coombs test (DCT), indicating the occurrence of hemolysis. Despite the increased need for blood transfusions, ABO blood group incompatibility (ABOi) had no negative impact on the clinical results. Conclusion Based on our findings, ABO incompatibility does not affect the outcomes in patients undergoing alloHSCT. Patient monitoring can aid in early detection and treatment, thereby minimizing the frequency of fatal events.
背景与目的 异基因造血干细胞移植（alloHSCT）为多种血液系统疾病提供了治愈性治疗。在本研究中，我们评估了ABO血型相合与不相合对在我们中心进行的针对各种血液系统疾病的造血干细胞移植（HSCT）的结局及并发症的影响。
方法 这是一项回顾性、单中心队列研究，患者根据ABO血型相合与不相合状态进行分类。不相合组进一步细分为主要不相合、次要不相合和双向不相合组。
结果 共有117例患者接受了alloHSCT，其中82例（70.1%）为男性，35例（30%）为女性。患者的中位年龄为9.5岁（范围：46岁）。干细胞移植最常见的适应证是重型β地中海贫血（BTM；n = 58，49%）和再生障碍性贫血（AA；n = 42，35.8%）。然而，相合组和不相合组的结局在直接抗人球蛋白试验（DCT）阳性方面显示出显著结果，提示溶血的发生。尽管输血需求增加，但ABO血型不相合（ABOi）对临床结果没有负面影响。
结论 根据我们的研究结果，ABO血型不相合并不影响接受alloHSCT患者的结局。对患者的监测有助于早期发现和治疗，从而将致命事件的发生率降至最低。
