ABO Blood Group Barrier in Allogeneic Bone Marrow Transplantation Revisited
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...
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Published in | Biology of blood and marrow transplantation Vol. 11; no. 12; pp. 1006 - 1013 |
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Main Authors | , , , , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
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United States
Elsevier Inc
01.12.2005
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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. |
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AbstractList | 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. 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 heterogeneous 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. 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 heterogeneous 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. |
Author | Reddy, Vijay Stussi, Georg Horowitz, Mary M. Goerner, Martin Elfenbein, Gerald J. Rowlings, Philip A. Gluckman, Eliane Gale, Robert Peter Seebach, Jörg D. Gajewski, James L. Klumpp, Thomas R. Keating, Armand Bolwell, Brian J. Loberiza, Fausto R. Barrett, A. John Tiberghien, Pierre Ringdén, Olle Passweg, Jakob R. van Rood, Jon J. |
Author_xml | – sequence: 1 givenname: Jörg D. surname: Seebach fullname: Seebach, Jörg D. organization: Department of Internal Medicine, University Hospital Zürich, Zürich, Switzerland – sequence: 2 givenname: Georg surname: Stussi fullname: Stussi, Georg organization: Department of Internal Medicine, University Hospital Zürich, Zürich, Switzerland – sequence: 3 givenname: Jakob R. surname: Passweg fullname: Passweg, Jakob R. organization: Department of Internal Medicine, University Hospital of Basel, Basel, Switzerland – sequence: 4 givenname: Fausto R. surname: Loberiza fullname: Loberiza, Fausto R. organization: University of Nebraska Medical Center, Omaha, Nebraska – sequence: 5 givenname: James L. surname: Gajewski fullname: Gajewski, James L. organization: M.D. Anderson Cancer Center, Houston, Texas – sequence: 6 givenname: Armand surname: Keating fullname: Keating, Armand organization: Department of Medical Oncology, Princess Margaret Hospital, Toronto, Ontario, Canada – sequence: 7 givenname: Martin surname: Goerner fullname: Goerner, Martin organization: Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany – sequence: 8 givenname: Philip A. surname: Rowlings fullname: Rowlings, Philip A. organization: Hunter Area Pathology Service, Newcastle Mater Hospital, University of Newcastle, Newcastle, Australia – sequence: 9 givenname: Pierre surname: Tiberghien fullname: Tiberghien, Pierre organization: Institut National de la Santé et de la Recherche Médicale, Etablissement Francais du Sang Bourgogne/Franche-Comté, Besançon, France – sequence: 10 givenname: Gerald J. surname: Elfenbein fullname: Elfenbein, Gerald J. organization: Medical Oncology/Hematology, Roger Williams Medical Center, Providence, Rhode Island – sequence: 11 givenname: Robert Peter surname: Gale fullname: Gale, Robert Peter organization: Center for Advanced Studies in Leukemia, Los Angeles, California – sequence: 12 givenname: Jon J. surname: van Rood fullname: van Rood, Jon J. organization: Europdonor Foundation, Leiden University Medical Center, Leiden, The Netherlands – sequence: 13 givenname: Vijay surname: Reddy fullname: Reddy, Vijay organization: Hematology/Oncology, University of Florida College of Medicine, Gainesville, Florida – sequence: 14 givenname: Eliane surname: Gluckman fullname: Gluckman, Eliane organization: Service d’Hematologie, Hopital Saint Louis, Paris, France – sequence: 15 givenname: Brian J. surname: Bolwell fullname: Bolwell, Brian J. organization: Hematology/Medical Oncology, Cleveland Clinic Foundation, Cleveland, Ohio – sequence: 16 givenname: Thomas R. surname: Klumpp fullname: Klumpp, Thomas R. organization: Fox Chase-Temple University BMT Program, Philadelphia, Pennsylvania – sequence: 17 givenname: Mary M. surname: Horowitz fullname: Horowitz, Mary M. email: marymh@mcw.edu organization: Center for International Blood and Marrow Transplant Research, Health Policy Institute, Medical College of Wisconsin, Milwaukee, Wisconsin – sequence: 18 givenname: Olle surname: Ringdén fullname: Ringdén, Olle organization: Department of Clinical Immunology, Huddinge University Hospital, Huddinge, Sweden – sequence: 19 givenname: A. John surname: Barrett fullname: Barrett, A. John organization: National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/16338623$$D View this record in MEDLINE/PubMed http://kipublications.ki.se/Default.aspx?queryparsed=id:1932973$$DView record from Swedish Publication Index |
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Copyright | 2005 American Society for Blood and Marrow Transplantation |
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Keywords | Bone marrow transplantation Engraftment GVHD ABO blood groups Survival |
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Snippet | Reports have shown a worse outcome for donor-recipient pairs mismatched for ABO blood groups in bone marrow transplantation (BMT). These studies, however,... |
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SubjectTerms | ABO blood groups ABO Blood-Group System Adolescent Adult Aged Blood Grouping and Crossmatching Bone marrow transplantation Bone Marrow Transplantation - methods Bone Marrow Transplantation - mortality Child Child, Preschool Disease-Free Survival Engraftment Erythrocyte Transfusion - methods Erythrocyte Transfusion - mortality Female Graft vs Host Disease - etiology Graft vs Host Disease - mortality GVHD Humans Infant Leukemia - mortality Leukemia - therapy Male Medicin och hälsovetenskap Middle Aged Retrospective Studies Survival Transplantation, Homologous Treatment Outcome |
Title | ABO Blood Group Barrier in Allogeneic Bone Marrow Transplantation Revisited |
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