Lai Dongdi, Chen Dandan, Chen Xiaowei, Zhou Ruiqing, Zhong Minglu, Chen Xiaojie, Huang Jianyun, Lan Yanfei, Tong Xinxin, Liu Zhen, Yang Xuexin, Wang Shunqing, Wei Yaming, Yuan Zhaohu
Department of Blood Transfusion, School of Medicine, The Second Affiliated Hospital, South China University of Technology, Guangzhou, 510180, China.
Department of Blood Transfusion, Guangzhou First Peoples Hospital, Guangzhou, 510180, China.
Ann Hematol. 2025 Mar;104(3):1931-1947. doi: 10.1007/s00277-025-06213-4. Epub 2025 Mar 19.
To investigate the impact of the ABO blood group major match type on stem cell engraftment, blood transfusion and clinical outcomes in aplastic anemia patients with hematopoietic stem cell transplantation (HSCT), we retrospectively analyzed the data of 361 aplastic anemia patients treated with HSCT, and found ABO major mismatched resulted in delayed red blood cells (RBCs) engraftment and ABO blood group conversion. The patients in the ABO major mismatched group required more units of RBCs and PLTs transfusions. Multivariate linear regression analysis showed that ABO mismatched, acute graft-versus-host disease (aGVHD), time to RBCs and PLTs engraftment and blood group conversion, and baseline hemoglobin were significantly associated with RBCs transfusion, the factors associated with PLTs transfusion were the PLTs, RBCs and neutrophils engraftment, graft rejection, baseline PLTs, aGVHD grade II-IV, and severe chronic GVHD. Multivariate analysis showed that the time to neutrophils engraftment, baseline hemoglobin, and aGVHD were independent poor prognostic factors to both overall survival and failure-free survival. Moreover, the major ABO-mismatched HSCT group were hospitalized more often. These findings suggest that it's better to select a donor with an ABO major match to reduce the burden of transfusion and the impact of hospitalization, if conditions permit.
为研究ABO血型主要匹配类型对接受造血干细胞移植（HSCT）的再生障碍性贫血患者干细胞植入、输血及临床结局的影响，我们回顾性分析了361例接受HSCT治疗的再生障碍性贫血患者的数据，发现ABO主要错配导致红细胞（RBC）植入延迟及ABO血型转换。ABO主要错配组患者需要更多单位的RBC和血小板输血。多因素线性回归分析显示，ABO错配、急性移植物抗宿主病（aGVHD）、RBC和血小板植入及血型转换时间，以及基线血红蛋白水平与RBC输血显著相关，与血小板输血相关的因素有血小板、RBC和中性粒细胞植入、移植物排斥、基线血小板水平、aGVHDⅡ-Ⅳ级及重度慢性GVHD。多因素分析显示，中性粒细胞植入时间、基线血红蛋白水平及aGVHD是总生存和无失败生存的独立不良预后因素。此外，ABO主要错配的HSCT组患者住院频率更高。这些发现表明，如果条件允许，最好选择ABO主要匹配的供体，以减轻输血负担和住院影响。
