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- W3040814522 abstract "The impact of ABO mismatch on outcomes following allo-HSCT remains controversial. In this study, our aim is to define the effect of ABO mismatch on post-transplant outcomes, engraftment kinetics and complications in a large cohort. We retrospectively identified 1000 patients who underwent allo-HSCT from either bone marrow or peripheral blood stem cells at our center between 1988 and 2016. P < 0.05 was considered statistically significant. Five hundred and ninety (59%) patient-donor pairs were ABO matched, 164 (16.4%) were ABO major mismatched (MM), 191 (19.1%) were ABO minor MM, and 55 (5.5%) were ABO bi-directionally MM. ABO matched pairs were more common in transplants from related donors (P < 0.001) and using bone marrow as a stem cell source (P < 0.001). In minor ABO MM transplantations, mild delayed hemolytic reaction occurred more frequently compared to major and bidirectional ABO MM transplantations (47% vs 35% and 18%, P < 0.001). Neutrophil engraftment was slightly delayed in ABO MM patient-donor pairs when compared ABO matched donor pairs according to median engraftment time in all group (167/410, 41% vs 204/590, 35%, P = 0.046). Pure red cell aplasia was diagnosed in 6 patients (1%). Higher risk of death was shown in ABO MM transplants compared to ABO matched transplants in overall survival (OS) analysis (HR:1.201, 95% CI:1.004–1.437, P = 0.045). The non-relapse mortality (P = 0.546) and cumulative incidences of acute graft versus host disease (aGVHD) and chronic (c) GVHD were comparable between ABO MM and ABO matched patient-donor pairs (for aGVHD, P = 0.235; for cGVHD, P = 0.137). ABO MM transplants were associated with decreased OS and slightly delayed neutrophil engraftment. NRM and the risk of GVHD were not related to ABO incompatibility. L’impact de l’ incompatibilité ABO sur les résultats après l’allogreffe de CSH reste controversé. Dans cette étude, notre objectif est de définir l’effet de différence ABO sur les résultats post-transplantation, la cinétique de greffe et les complications dans une grande cohorte. Nous avons rétrospectivement identifié 1000 patients avec greffe de la moelle osseuse ou des cellules souches du sang périphérique dans notre centre entre 1988 et 2016. p < 0,05 a été considéré comme statistiquement significatif. Au total, 590 (59 %) paires patient-donneur étaient ABO compatibles, 164 (16,4 %) étaient ABO major non compatibles (MNC), 191 (19,1 %) étaient ABO minor NC et 55 (5,5 %) ABO bidirectionnelles NC. Les paires ABO compatibles étaient plus fréquentes dans les greffes de donneurs relatifs (p < 0,001) et utilisant la moelle osseuse comme source de cellules souches (p < 0,001). Dans les transplantations ABO NC mineures, une légère réaction hémolytique retardée est survenue plus fréquemment que les transplantations ABO NC majeures et bidirectionnelles (47 % vs. 35 % et 18 %, p < 0,001). La greffe de neutrophiles était légèrement retardée dans les paires patient-donneur ABO NC par rapport aux paires de donneurs ABO appariés en fonction du temps médian de greffe dans tous les groupes (167/410, 41 % vs. 204/590, 35 %, p = 0,046). Une aplasie érythrocytaire pure a été diagnostiquée chez 6 patients (1 %). Un risque plus élevé de décès a été montré dans les transplantations ABO NC par rapport aux transplantations appariées ABO dans l’analyse de la survie globale (OS) (HR : 1,201, IC à 95 % : 1,004–1,437, p = 0,045). La mortalité sans rechute (p = 0,546) et les incidences cumulées de la maladie aiguë du greffon contre l’hôte (aGVHD) et chronique (c) GVHD étaient comparables entre les paires patient-donneur ABO NC et ABO (pour aGVHD, p = 0,235 ; pour cGVHD), p = 0,137). Les greffes ABO NC étaient associées avec une diminution de la survie globale et avec la greffe de neutrophiles légèrement retardée. La mortalité sans rechute et le risque de GVHD n’étaient pas liés à l’incompatibilité ABO." @default.
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- W3040814522 date "2020-08-01" @default.
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- W3040814522 title "Effects of ABO incompatibility in allogeneic hematopoietic stem cell transplantation" @default.
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- W3040814522 doi "https://doi.org/10.1016/j.tracli.2020.06.008" @default.
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