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14 June 2019 : Original article  

ABO Blood Type Incompatibility Is Not a Risk Factor of Outcomes for Acute Myeloid Leukemia (AML) Patients After Unmanipulated Haplo-identical Peripheral Blood Hematopoietic Stem Cell Transplantation

Nan Yang1ABCDEF, Lixun Guan1DEF, Zhanxiang Liu1BE, Yi Ding1B, Chengying Zhu1C, Lan Luo1B, Feiyan Wang1B, Shu Fang1B, Zhe Gao1F, Zhenyang Gu1A, Chunji Gao1ACDEFG*

DOI: 10.12659/AOT.916004

Ann Transplant 2019; 24:350-358

Abstract

BACKGROUND: Haplo-identical hematopoietic stem cell transplantation (HSCT) has provided potential donors for patients lacking available HLA-matched donors. ABO blood type compatibility has been reported to be associated with HSCT outcomes. However, few studies have investigated the role of ABO compatibility in haplo-identical HSCT of AML patients.

MATERIAL AND METHODS: We retrospectively analyzed 42 adult acute myeloid leukemia (AML) patients who received unmanipulated haplo-identical peripheral blood HSCT at the Chinese PLA General Hospital between Jan 2013 and Dec 2017. We analyzed the role of ABO compatibility in engraftment, transfusion requirements, cytomegalovirus (CMV) and Epstein-Barr virus (EBV) viremia, acute graft-versus-host disease (GVHD), overall survival (OS), transplantation-related mortality (TRM), relapse, chronic GVHD, and post-transplant lymphoproliferative disorder (PTLD).

RESULTS: There were no significant differences between the ABO-matched group and the ABO-mismatched group in terms of engraftment, transfusion requirements, CMV and EBV viremia, OS, TRM, relapse, PTLD, and chronic GVHD. Univariate analysis revealed ABO incompatibility is not an independent risk factor of engraftment, transfusion requirements, CMV and EBV viremia, OS, TRM, relapse, PTLD, and chronic GVHD. We found a significantly higher cumulative incidence of aGVHD in the matched group compared with the mismatched group (80.95% vs. 42.86%, p=0.020). In multivariate analysis, ABO mismatch was associated with decreased risk of acute GVHD within 100 days after transplant (hazard ratio 0.492, 95% confidence interval 0.2123–1.14). However, the difference was not statistically significant (p=0.099).

CONCLUSIONS: This study demonstrated ABO incompatibility is not an independent risk factor of outcomes for AML patients who received unmanipulated haplo-identical peripheral blood HSCT. ABO compatibility might have limited value in haplo-identical donor selection.

Keywords: Blood Group Incompatibility, Haploidy, Leukemia, Myeloid, Acute, ABO Blood-Group System, Adolescent, Middle Aged, Peripheral Blood Stem Cell Transplantation, Prognosis, Retrospective Studies, Risk Factors, Treatment Outcome, young adult

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358