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A study of blood group conversion in patients with ABO incompatible hematopoietic stem cell transplantation—A decade survey

  • Guining Li
    Affiliations
    Department of Blood Transfusion Medicine, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jie Fang Road, 430022 Wuhan City, Hubei Province, PR China
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  • Fenghua Chen
    Correspondence
    Corresponding author.
    Affiliations
    Department of Blood Transfusion Medicine, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jie Fang Road, 430022 Wuhan City, Hubei Province, PR China
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  • Ning Wang
    Affiliations
    Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jie Fang Road, 430022 Wuhan City, Hubei Province, PR China
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  • Min Zhang
    Affiliations
    Department of Blood Transfusion Medicine, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jie Fang Road, 430022 Wuhan City, Hubei Province, PR China
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  • Xueliang Lu
    Affiliations
    Department of Blood Transfusion Medicine, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jie Fang Road, 430022 Wuhan City, Hubei Province, PR China
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  • Haijing Chen
    Affiliations
    Department of Blood Transfusion Medicine, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jie Fang Road, 430022 Wuhan City, Hubei Province, PR China
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  • Xiujuan Wang
    Affiliations
    Department of Blood Transfusion Medicine, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jie Fang Road, 430022 Wuhan City, Hubei Province, PR China
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Published:September 08, 2022DOI:https://doi.org/10.1016/j.transci.2022.103576

      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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