Abstract
Background
ABO incompatibility is not a contraindication but would affect the prognosis of allogeneic
hematopoietic stem cell transplantation (allo-HSCT). The dynamic change of blood phenotype
is not only related to the patient's status, but also the basis for the implementation
of compatible blood transfusion. The criteria for judging a complete transformation
to donor-type and the principle of blood transfusion at relapse need to be unified.
We aimed to illustrate the significance of blood group monitoring after allo-HSCT.
Material and methods
We collected 263 patients underwent ABO incompatible allo-HSCT from January 2010 to
December 2019, and monitored blood type regularly according to the frequency of the
patient's return visits till complete conversion or death. Non-parametric test was
used to find differences among incompatible groups. We analyzed factors potentially
influence blood type conversion by Binary Logistic model. Cox regression model was
used to illustrate the relationship between blood-type conversion and prognosis.
Results
The median days of conversion were 107, 91 and 108 in major-, minor- and bidirectional
groups respectively. Blood type conversion correlated with HLA compatibility (P = 0.012,
OR=2.69) and acute graft-versus-host-disease (P = 0.001, OR=0.06). Patients with incomplete
blood type conversion had a higher death rate than those with complete blood type
conversion(P = 0.003, OR=3.703).
Discussion
Blood type monitoring can help to evaluate the prognosis of transplantation and assess
the risk of death. It is recommended to monitor the changes of blood group antigens
and antibodies, especially within a year after transplantation, to predict the risk
of adverse events (such as GVHD, recurrence, death, etc.).
Keywords
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References
- Post-hematopoietic stem cell transplantation immune-mediated anemia: a literature review and novel therapeutics.Blood Adv. 2021; (bloodadvances.2021006279. Online ahead of print)
- ABO mismatch in allogeneic hematopoietic stem cell transplant: effect on short- and long-term outcomes.Transpl Direct. 2021; 7e724
- Haemolysis, pure red cell aplasia and red cell antibody formation associated with major and bidirectional ABO incompatible haematopoietic stem cell transplantation.Blood Transfus. 2018; 16: 397-404
- A limitation of fluorescence in situ hybridization (FISH) assays targeting sex chromosomes for monitoring of early relapse after transplantation.Transplantation. 2001; 71: 581-583
- Short tandem repeats (STRs) as biomarkers for the quantitative follow-up of chimerism after stem cell transplantation: methodological considerations and clinical application.Genes. 2020; 11: 993
X.Y. Wang, Y.J. Chang, Y.R. Liu, et al. Comparison of prognostic significance between multiparameter flow cytometry and real-time quantitative polymerase chain reaction in the detection of minimal residual disease of Philadelphia chromosome-positive acute B lymphocytic leukemia before allogeneic hematopoietic stem cell transplantation.Zhonghua Xue Ye Xue Za Zhi. 2021 Feb 14;42(2):116–123.
- The applicability of multiparameter flow cytometry for the detection of minimal residual disease using different-from-normal panels to predict relapse in patients with acute myeloid leukemia after allogeneic transplantation.Int J Lab Hematol. 2019; 41: 607-614
- Persistence of recipient-type endothelium after allogeneic hematopoietic stem cell transplantation.Haematologica. 2011; 96: 119-127
- Passenger lymphocyte syndrome after ABO-incompatible allogeneic hematopoietic stem cell transplantation; dynamics of ABO allo-antibody and blood type conversion.Hematology. 2021; 26: 835-839
- A case of mixed antibodies produced after peripheral blood hematopoietic stem cell transplantation.J Clin Hematol. 2017; 30: 487-489
- Transfusion policy in ABO-incompatible allogeneic stem cell transplantation.Vox Sang. 2010; 98: 455-467
- Analysis of donor and recipient ABO incompatibility and antibody-associated complications after allogeneic stem cell transplantation with reduced-intensity conditioning.Biol Blood Marrow Transpl. 2014; 20: 264-271
Article info
Publication history
Published online: September 08, 2022
Accepted:
September 6,
2022
Received in revised form:
September 3,
2022
Received:
April 5,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
