Andrić Biljana, Radonjić Zorica, Šerbić Olivera, Vujić Dragana, Zečević Željko, Simić Marija, Gobeljić Borko, Jovanović-Srzentić Snežana, Radović Ivana
Mother and Child Health Care Institute of Serbia "Dr. Vukan Čupić", Belgrade, Serbia.
Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Transfus Med Hemother. 2024 May 28;51(6):439-443. doi: 10.1159/000536176. eCollection 2024 Dec.
ABO blood type changes after ABO-incompatible hematopoietic stem cell transplantation (HSCT). Most non-hematopoietic tissues retain the expression of the patient's own ABO antigens, which may adsorb from the plasma onto the donor's red blood cells (RBCs). Because of this phenomenon, a persistent patient's A and/or B antigen could be detected in the laboratory, despite 100% white cell donor chimerism. Adsorption of the patient's soluble ABO antigens on the newly formed RBCs complicates the interpretation of the patient's blood type and decision of transfusion therapy.
The first case report is a 6-year-old girl, A, D+, with T-cell acute lymphoblastic leukemia (ALL), transplanted with HLA-matched unrelated group O, D+ bone marrow. A second case report describes an 8-year-old girl, AB, D-, with ALL transplanted with an HLA-matched related group B, D+ bone marrow. The presence of persistent antigen A was registered in both patients more than 1 year after HSCT, despite complete donor chimerism.
The weak expression of ABO antigens on RBCs after HSCT should be examined in detail for proper planning of transfusion therapies.
ABO血型在ABO血型不相合的造血干细胞移植（HSCT）后会发生改变。大多数非造血组织会保留患者自身ABO抗原的表达，这些抗原可能会从血浆吸附到供体红细胞（RBC）上。由于这种现象，尽管白细胞供体嵌合率达到100%，但在实验室中仍可检测到患者持续存在的A和/或B抗原。患者可溶性ABO抗原吸附到新形成的RBC上，使得对患者血型的解读以及输血治疗决策变得复杂。
第一例病例是一名6岁女孩，A型、RhD阳性，患有T细胞急性淋巴细胞白血病（ALL），接受了与HLA匹配的无关供者O型、RhD阳性骨髓移植。第二例病例报告描述了一名8岁女孩，AB型、RhD阴性，患有ALL，接受了与HLA匹配的亲属供者B型、RhD阳性骨髓移植。尽管供体完全嵌合，但在HSCT后1年多，两名患者均检测到持续存在的抗原A。
为了合理规划输血治疗，应详细检查HSCT后RBC上ABO抗原的弱表达情况。
