Minor ABO-Mismatches are Risk Factors for Acute Graft-versus-Host Disease in Hematopoietic Stem Cell Transplant Patients

Ludajic, Katarina; Balavarca, Yesilda; Bickeböller, Heike; Rosenmayr, A.; Fischer, Gottfried; Faé, Ingrid; Kalhs, Peter; Pohlreich, David; Kouba, Michal; Dobrovolná, Marie; Greinix, Hildegard

doi:10.1016/j.bbmt.2009.07.002

Cited by 24 publications

(27 citation statements)

References 31 publications

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“…In a study of 174 patients by Bacigalupo et al [15], minor ABO mismatch was associated with a significantly higher risk of severe acute GVHD when compared with ABO-matched and major ABO-mismatched pairs. 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%).…”

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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show abstract

“…Minor ABO incompatibility has been associated with increased incidence of acute GVHD in populations who have received an allogeneic BM or PBSC transplant [34]. This increase in aGVHD is due to donor T cell sensitization against recipient ABO glycosyltransferase-derived peptides [35], which act as minor histocompatibility antigens and trigger an adaptive immune response.…”

Section: Discussionmentioning

confidence: 99%

Impact of Graft–Recipient ABO Compatibility on Outcomes after Umbilical Cord Blood Transplant for Nonmalignant Disease

Kudek

Shanley

Zantek

et al. 2016

Biology of Blood and Marrow Transplantation

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Existing literature shows mixed conclusions regarding the impact of ABO incompatibility on outcomes after hematopoietic stem cell transplantation. Because the future for umbilical cord blood (UCB) expansion technologies is bright, we assessed whether this typically overlooked graft characteristic impacted various outcomes after UCB transplantation (UCBT) for nonmalignant disorders (NMDs). A prospectively maintained institutional blood and marrow transplant program database was queried for all patients undergoing first UCBT for NMDs. UCB and recipient ABO compatibility was considered as matched, major mismatched, minor mismatched, or bidirectional mismatched. The impact of ABO incompatibility was assessed on overall survival, graft failure, acute and chronic graft-versus-host disease (GVHD), time to neutrophil and platelet recovery, day 0 to day 100 RBC transfusion burden, and donor hematopoietic chimerism. Through December 2014, 270 patients have undergone first UCBT for various NMDs. In both univariable and multivariable analyses, ABO compatibility status did not appear to impact any outcomes assessed, although a trend toward increased grades III to IV acute GVHD was seen in recipients of major mismatched units. When considering UCBT for treatment of NMDs, ABO compatibility between the donor unit and intended recipient does not appear to be an important consideration in the UCB unit choice.

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“…Recent studies showed that minor and major ABO incompatibility can be associated with a higher incidence of GVHD and may also have a negative impact on outcome. [19][20][21] Endothelial replacement and chimerism by donor bone marrow-derived cells might play a role in ABO-incompatibility; theoretically it could be a result of rejection and eventually favor the development of ABO tolerance.…”

Section: Introductionmentioning

confidence: 99%

Persistence of recipient-type endothelium after allogeneic hematopoietic stem cell transplantation

Mueller¹,

Stüssi²,

Yung³

et al. 2010

Haematologica

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Minor ABO-Mismatches are Risk Factors for Acute Graft-versus-Host Disease in Hematopoietic Stem Cell Transplant Patients

Cited by 24 publications

References 31 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

Impact of Graft–Recipient ABO Compatibility on Outcomes after Umbilical Cord Blood Transplant for Nonmalignant Disease

Persistence of recipient-type endothelium after allogeneic hematopoietic stem cell transplantation

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