ABO blood group barrier in allogeneic bone marrow transplantation revisited

Jörg D. Seebach, Georg Stussi, Jakob R. Passweg, Fausto R. Loberiza, James L. Gajewski, Armand Keating, Martin Goerner, Philip A. Rowlings, Pierre Tiberghien, Gerald J. Elfenbein, Robert Peter Gale, Jon J. van Rood, Vijay Reddy, Eliane Gluckman, Brian J. Bolwell, Thomas R. Klumpp, Mary M. Horowitz, Olle Ringdén, A. John Barrett

    Research output: Contribution to journalArticle

    95 Scopus citations

    Abstract

    Reports have shown a worse outcome for donor-recipient pairs mismatched for ABO blood groups in bone marrow transplantation (BMT). These studies, however, included small and heterogenous study populations, and not all considered bidirectional ABO incompatibility separately. Because the issue remains controversial, we analyzed the effect of ABO mismatch on the overall survival, transplant-related mortality, and occurrence of acute and chronic graft-versus-host disease (GVHD) in a large homogenous group of patients undergoing allogeneic BMT. A total of 3103 patients with early-stage leukemia who underwent transplantation between 1990 and 1998 with bone marrow from an HLA-identical sibling and who were reported to the Center for International Blood and Marrow Transplant Research were studied. The median follow-up was 54 months. A total of 2108 (67.9%) donor-recipient pairs were ABO identical, 451 (14.5%) had a minor mismatch, 430 (13.9%) had a major mismatch, and 114 (3.7%) had a bidirectional ABO mismatch. The groups did not differ significantly in patient or donor characteristics except for more female-to-male sex mismatch in the bidirectional ABO mismatch group (P = .017). In multivariate models of overall survival, transplant-related mortality, and grade II to IV acute GVHD, there were no significant differences among the 4 groups. Bidirectional ABO mismatch was associated with a significantly higher risk of grade III or IV acute GVHD (hazard ratio, 1.869; 95% confidence interval, 1.192-2.93; P = .006). Patients with major ABO mismatch received red blood cell transfusions (P = .001) for a longer timer after transplantation and had a slightly slower neutrophil recovery (P < .001). There was no evidence of a substantial effect of ABO blood group incompatibility on the outcome of conventional BMT among patients with leukemia.

    Original languageEnglish (US)
    Pages (from-to)1006-1013
    Number of pages8
    JournalBiology of Blood and Marrow Transplantation
    Volume11
    Issue number12
    DOIs
    StatePublished - Dec 1 2005

    Keywords

    • ABO blood groups
    • Bone marrow transplantation
    • Engraftment
    • GVHD
    • Survival

    ASJC Scopus subject areas

    • Hematology
    • Transplantation

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  • Cite this

    Seebach, J. D., Stussi, G., Passweg, J. R., Loberiza, F. R., Gajewski, J. L., Keating, A., Goerner, M., Rowlings, P. A., Tiberghien, P., Elfenbein, G. J., Gale, R. P., van Rood, J. J., Reddy, V., Gluckman, E., Bolwell, B. J., Klumpp, T. R., Horowitz, M. M., Ringdén, O., & Barrett, A. J. (2005). ABO blood group barrier in allogeneic bone marrow transplantation revisited. Biology of Blood and Marrow Transplantation, 11(12), 1006-1013. https://doi.org/10.1016/j.bbmt.2005.07.015