Impact of ABO incompatibility on allogeneic peripheral blood progenitor cell transplantation after reduced intensity conditioning

Abstract

ABO incompatibility was not associated with clinically relevant hemolysis after the RIC protocol used and did not impair the clinical outcome. PRCA was only observed in one patient, with a non-ABO RBC allo-antibody.

Impact of ABO blood group mismatch in alemtuzumab-based reduced-intensity conditioned haematopoietic SCT

“…39,40 In the context of RIC HSCT, our study adds to a body of work to suggest that ABO mismatch has no significant impact on survival, TRM or relapse, irrespective of stem cell source (PBSC and marrow). 1,3,22,[43][44][45] In addition, a recent study by Romee et al 41 has shown no effect from ABO mismatch in umbilical cord HSCT. We found no significant effect of ABO mismatch on time to neutrophil and PLT engraftment, with a similar median engraftment time to previous HSCT studies.…”

“…This is in contrast to previous ABO mismatch studies that noted increased duration and absolute number of RBC transfusions after MJ and BD mismatch and increased PLT transfusion requirements in MN mismatch. 3,7,22,48 PBSC and RIC have both been associated with increased severity of passenger lymphocyte syndrome in patients with MN ABO mismatch, thought secondary to increased numbers of immunocompetent CD3+ T cells and CD19+ B cells transplanted along with a PBSC graft. [49][50][51][52] .…”

“…21 The impact of ABO mismatch on transplant outcomes is variable, with a number of small and heterogeneous studies in the literature. 4,8,[22][23][24][25][26][27][28][29] Of the larger studies, a French registry study of 1108 RIC HSCT patients reported that MN ABO incompatibility was associated with reduced OS. 30 In the RIC subgroup of the largest registry study to date, Kimura et al 2 reported increased transplantrelated mortality (TRM) for MN, MJ and BD ABO-mismatched patients.…”

Lack of effect of donor–recipient ABO mismatching on outcome following allogeneic hematopoietic stem cell transplantation

“…[1][2][3][4][5][6][7][8][9][10][11][12] However, the literature contains strikingly disparate opinions regarding the potential effect of ABO mismatching on other important outcome parameters including the incidence of death, relapse, graft-versus-host disease (GVHD), and transplant-related-mortality. Specifically, various investigators have concluded that ABO mismatching increases, [13][14][15][16][17][18][19][20][21] does not affect, [22][23][24][25][26][27][28][29][30][31][32] or decreases, [33][34] the incidence of one or more of the latter events.…”

Major ABO-incompatible BMT: isohemagglutinin reduction with plasma exchange is safe and avoids graft manipulation

“…5,10 Conversely, some have found that ABO incompatibility has no significant impact on these outcomes. [11][12][13] The variability in reported outcomes may reflect differences in patient populations, progenitor cell source, conditioning and GVHD-prophylaxis. In addition, there is no current consensus on the best management of donor-recipient ABO incompatibility.…”