Allogeneic peripheral blood stem cell transplantation using reduced‐intensity conditioning in an outpatient setting in <scp>ABO</scp>‐incompatible patients: are survival and graft‐versus‐host disease different?

Gutiérrez-Aguirre, César Homero; Gómez-De-León, Andrés; Alatorre-Ricardo, Julio; Cantú-Rodrı́guez, Olga Graciela; González-Llano, Óscar; Jaime‐Pérez, José Carlos; Mancı́as-Guerra, Consuelo; Flores-Jiménez, Juan Antonio; Gómez‐Almaguer, David

doi:10.1111/trf.12466

Cited by 17 publications

(16 citation statements)

References 38 publications

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“…Ludajic et al [27] observed that a minor ABO-mismatch represents a significant risk factor for acute GVHD (grade II–IV) with an estimated risk increase of almost 3-fold, and even 4-fold for severe acute GVHD (grade III–IV). Gutiérrez-Aguirre et al [28] analyzed a cohort of patients exclusively receiving RIC and found the highest rate of acute GVHD in minor ABO-mismatched transplant recipients (25%) compared with ABO-identical (20.5%) and major ABO-mismatched cases (15.4%). Other publications observe no influence of ABO mismatch on the incidence of clinically significant acute GVHD [6, 29].…”

Section: Discussionmentioning

confidence: 99%

Donor-to-Recipient ABO Mismatch Does Not Impact Outcomes of Allogeneic Hematopoietic Cell Transplantation Regardless of Graft Source

Damodar

Shanley

MacMillan

et al. 2017

Biology of Blood and Marrow Transplantation

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The impact of ABO mismatch has been studied on various hematopoietic cell transplant (HCT) outcomes including neutrophil and platelet engraftment, pure red cell aplasia (PRCA), acute and chronic GVHD, non-relapse mortality (NRM) and overall survival (OS). Yet conflicting results have been reported. However, the impact of ABO mismatch on transplant outcomes with various graft types has not been carefully investigated. We analyzed the impact of various graft sources and type of ABO mismatch on transplant outcomes for 1502 patients who underwent HCT at the University of Minnesota, between 2000–2014: 312 receiving marrow (BM), 475 filgrastim-mobilized blood (PBSC), and 715 cord blood (UCB) grafts. Neutrophil engraftment by day 28 was marginally less frequent in the bidirectional ABO mismatched transplants receiving UCB while ABO matching had no influence on engraftment in the BM or PBSC cohorts. ABO mismatch led to no significant differences in platelet engraftment irrespective of stem cell source. We observed a modest, but not significantly lower incidence of grade II/IV acute GVHD in the bidirectional ABO mismatched transplants in the UCB and the PBSC cohorts, but not in the BM group. We found a higher incidence of chronic GVHD in the PBSC group, but it was not significantly lower in the minor ABO mismatched transplants. The incidence of chronic GVHD was similar in the major ABO mismatched transplants receiving BM. We found no significant difference in the overall survival (OS) and non-relapse mortality (NRM) between the ABO matched and the ABO mismatched transplants within each of the three graft source groups. Multivariable analysis adjusting for other relevant factors confirmed that ABO match status did not significantly influence the outcomes of either engraftment, acute or chronic GVHD or NRM. We conclude that ABO mismatch does not influence the outcomes of allogeneic HCT, regardless of stem cell source.

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Section: Discussionmentioning

confidence: 99%

Donor-to-Recipient ABO Mismatch Does Not Impact Outcomes of Allogeneic Hematopoietic Cell Transplantation Regardless of Graft Source

Damodar

Shanley

MacMillan

et al. 2017

Biology of Blood and Marrow Transplantation

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“…MSCs from the bone marrow (BM-MSCs) were originally described by Friedenstein et al as non-phagocytic and non-hematopoietic cells and adherent to plastic [4]. Over the last 15 years, there has been an explosion in the reports of MSCs isolated from a variety of other adult sources, including skin [5], adipose tissue [6], umbilical cord blood [7,8] and matrix, peripheral blood [9], tendons [10,11], amnion [12][13][14], and bone [15][16][17]. Their plasticity, immunosuppressive potential, immuno-modulatory properties [18,19], and trophic activity [20,21] make MSCs critical players in tissue homeostasis.…”

Section: Introductionmentioning

confidence: 99%

Enhanced osteogenic potential of mesenchymal stem cells from cortical bone: a comparative analysis

et al. 2015

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Introduction: Mesenchymal stem cells (MSCs) hold great promise for regenerative therapies in the musculoskeletal system. Although MSCs from bone marrow (BM-MSCs) and adipose tissue (AD-MSCs) have been extensively characterized, there is still debate as to the ideal source of MSCs for tissue-engineering applications in bone repair. Methods: MSCs were isolated from cortical bone fragments (CBF-MSCs) obtained from patients undergoing laminectomy, selected by fluorescence-activated cell sorting analysis, and tested for their potential to undergo mesodermic differentiation. CBF-MSCs were then compared with BM-MSCs and AD-MSCs for their colony-forming unit capability and osteogenic potential in both normoxia and hypoxia. After 2 and 4 weeks in inducing media, differentiation was assessed qualitatively and quantitatively by the evaluation of alkaline phosphatase (ALP) expression and mineral deposition (Von Kossa staining). Transcriptional activity of osteoblastogenesis-associated genes (Alp, RUNX2, Spp1, and Bglap) was also analyzed. Results: The cortical fraction of the bone contains a subset of cells positive for MSC-associated markers and capable of tri-lineage differentiation. The hypoxic conditions were generally more effective in inducing osteogenesis for the three cell lines. However, at 2 and 4 weeks, greater calcium deposition and ALP expression were observed in both hypoxic and normoxic conditions in CBF-MSCs compared with AD-and BM-MSCs. These functional observations were further corroborated by gene expression analysis, which showed a significant upregulation of Bglap, Alp, and Spp1, with a 22.50 (±4.55) -, 46.56 (±7.4)-, 71.46 (±4.16)-fold increase compared with their uninduced counterparts. Conclusions: This novel population of MSCs retains a greater biosynthetic activity in vitro, which was found increased in hypoxic conditions. The present study demonstrates that quantitative differences between MSCs retrieved from bone marrow, adipose, and the cortical portion of the bone with respect to their osteogenic potential exist and suggests the cortical bone as suitable candidate to use for orthopedic tissue engineering and regenerative medicine.

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“…All but one of the studies reporting on the incidence of GVHD showed no influence of ABO-mismatched transplantation on development or severity of chronic GVHD. Gutiérrez-Aguirre et al [46] observed a higher incidence of chronic GVHD in the context of minor ABO mismatch (35%), in contrast to ABO-identical (30.8%) and major ABO-mismatched transplants.…”

Section: Graft-versus-host Diseasementioning

confidence: 99%

“…However, results of cohort and registry studies are conflicting. Two registry studies found a higher risk for NRM in the RIC cohort, one of those also for major ABO-mismatched cases if myeloablative conditioning was applied [6,36], whereas some cohort studies observed an increased risk for patients after minor, major or bi-directional ABO-mismatched transplants [4,8,46] (table 2).…”

Section: Non-relapse Mortalitymentioning

confidence: 99%

“…Ludajic et al [45] observed that a minor ABO-mismatch represents a significant risk factor for acute GVHD (grade II-IV) with an estimated risk increase of almost 3-fold, and even 4-fold for severe acute GVHD (grade III-IV). Recently, Gutiérrez-Aguirre et al [46] analyzed a cohort of patients exclusively receiving RIC and found the highest rate of acute GVHD in minor ABO-mismatched transplant recipients (25%) compared with ABO-identical (20.5%) and major ABO-mismatched cases (15.4%). Other publications did not observe any influence of ABO mismatch on the incidence of clinically significant acute GVHD [8,23,37].…”

Section: Graft-versus-host Diseasementioning

confidence: 99%

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ABO-Mismatched Allogeneic Hematopoietic Stem Cell Transplantation

Worel

2015

Transfus Med Hemother

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Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative option for a variety of malignant and non-malignant hematological and congenital diseases. Due to the fact that the human leukocyte antigen system is inherited independently of the blood group system, approximately 40-50% of all HSCTs are performed across the ABO blood group barrier. The expected immune-hematological consequences after transplantation of an ABO-mismatched stem cell graft are immediate and delayed hemolytic complications due to presence of isohemagglutinins or passenger lymphocyte syndrome. The risks of these complications can partially be prevented by graft manipulation and appropriate transfusion support. Dependent on the kind of ABO mismatch, different effects on engraftment have been observed, e.g. delayed red blood cell recovery and pure red cell aplasia. Data on incidence of acute graft-versus-host disease (GVHD), non-relapse mortality, relapse, and overall survival are inconsistent as most studies include limited patient numbers, various graft sources, and different conditioning and GVHD prophylaxis regimens. This makes it difficult to detect a consistent effect of ABO-mismatched transplantation in the literature. However, knowledge of expectable complications and close monitoring of patients helps to detect problems early and to treat patients efficiently, thus reducing the number of fatal or life-threatening events caused by ABO-mismatched HSCT.

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Allogeneic peripheral blood stem cell transplantation using reduced‐intensity conditioning in an outpatient setting in ABO‐incompatible patients: are survival and graft‐versus‐host disease different?

Abstract: Using this type of peripheral blood stem cell transplantation, minor ABO-mismatched allo-HSCT was associated with a higher incidence of aGVHD and cGVHD and with increased survival, albeit with no significance.

Cited by 17 publications

References 38 publications

Donor-to-Recipient ABO Mismatch Does Not Impact Outcomes of Allogeneic Hematopoietic Cell Transplantation Regardless of Graft Source

Donor-to-Recipient ABO Mismatch Does Not Impact Outcomes of Allogeneic Hematopoietic Cell Transplantation Regardless of Graft Source

Enhanced osteogenic potential of mesenchymal stem cells from cortical bone: a comparative analysis

ABO-Mismatched Allogeneic Hematopoietic Stem Cell Transplantation

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