Effect of ABO-Incompatibility on Outcome of Allogeneic Hematopoietic Stem Cell Transplantation

Objective: To investigate the effect of ABO-incompatibility on the efficacy and complications of allogeneic hematopoietic stem cell transplantation(HSCT).

Methods: The clinical data of 54 recipients who received ABO-incompatible allo-HSCT were retrospectively analyzed and were compared with 54 ABO-identical recipients as controls. Hematopoietic reconstruction and the blood type conversion time were dynamically observed and compared between 2 groups.

Results: The time of erythrocyte reconstitution was prolonged to 24 d in ABO-incompatible group, compared with that of 19 d in ABO-compatible group (P<0.01). The difference of neutrophil and platelet reconstruction was not statistically significant (P>0.05). Major mismatch group and bidirectional mismatch group required more erythrocyte transfusions than that of ABO-compatible group. The surface antigen of erythrocyte change in major mismatch group was earlier than that of minor mismatch group (P<0.05). The incidence of cytomegalovirus (CMV) infection, acute graft versus host disease (aGVHD) and survival were not significantly different between 2 groups.

Conclusions: ABO-incompatibility can not influence the effect of allo-HSCT, but ABO-incompatibility delayed erythrocyte recovery, and required more RBC and platelet transfusions.