ABO incompatibility does not influence transfusion requirements in patients undergoing single-unit umbilical cord blood transplantation

Abstract

Hematopoietic stem cell transplantation is usually performed without considering the ABO compatibility between donor and recipient. There are few studies analyzing ABO matching impact on transfusion outcome of umbilical cord blood transplantation (UCBT) recipients. The aim of this study was to analyze factors influencing transfusion outcome, highlighting the ABO matching between donor and recipient. This study has reviewed data from 318 patients who underwent single unit UCBT at la Fe University Hospital from January 2000 to December 2014. There were no differences between RBC and platelet (PLT) requirements or RBC and PLT transfusion independence according to ABO matching between donor and recipient. RBC and PLT requirements were statistically correlated (ρ=0,841, P<0.001). A total of 170 and 188 patients achieved RBC and PLT independence, respectively, within 180 days after UCBT. Persistence of recipient isoagglutinins was detected in 6.8% of patients with major ABO incompatibility at median of 176 days (103-269) after UCBT. Autoimmune haemolytic anemia was diagnosed in 15 patients, 12 of them due to cold antibodies. In conclusion, ABO matching has not influenced transfusion requirements of patients undergoing UCBT.

RBC and platelet transfusion support in the first 30 and 100 days after haploidentical hematopoietic stem cell transplantation

“…Not surprisingly, major ABO incompatibility was associated with significantly increased RBC transfusions during both time periods. This association has been frequently, but not consistently, observed in studies of recipients of other types of allo‐HSCTs …”

“…The median number of days to achieve RBC and platelet transfusion independence were 34 days (95% confidence interval, or 95% CI: [28][29][30][31][32][33][34][35][36][37][38][39][40] independence, and 89.5% (95% CI: 83.5%-93.4%) had achieved platelet independence ( Table 2, and Fig. 1A and B).…”

“…Among the transfused patients, medians of 5 units (interquartile range [IQR] = 3-8) of RBCs and 11 units (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) platelets were given in the first 30 days, and medians of 3 units (IQR = 1-7) of RBCs and 6 units (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) of platelets were transfused between days 31 and 100. Median times for achieving RBC and platelet transfusion independence were 34 (95% CI: [28][29][30][31][32][33][34][35][36][37][38][39][40]) and 25 (95% CI: 23-27) days, respectively. Multivariable analyses showed that RBC transfusions in the 10 days before HSCT were associated with significantly increased and sustained RBC and platelet transfusion requirements.…”

Increased blood transfusion after outpatient autologous transplantation with reduced intensity conditioning for hematological malignancies predicts worse outcomes

“…In contrast to these reports on patients receiving reduced intensity regimens, a study where 93% of the patients underwent auto‐HSCT after a myeloablative regimen reported that 90% required transfusion support 23 . The lower transfusion support demand with RIC versus myeloablative conditioning regimens has been well documented previously 24,25 …”

Comparison of transfusion requirements in adult patients undergoing Haploidentical or single‐unit umbilical cord blood stem cell transplantation

“…UCBT procedures including conditioning regimes, GVDH prophylaxis, and supportive care have been previously reported. 4,12 For haplo-HSCT, G-CSF mobilized peripheral blood stem cells were used as graft source, without further manipulation. The conditioning regimen consisted of either a conventional myeloablative regimen (MAC) or a reduced intensity conditioning (RIC) for patients unfit to receive MAC.…”