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Frequency and prognostic value of D alloantibodies after D‐mismatched allogeneic hematopoietic stem cell transplantation after reduced‐intensity conditioning
Author(s) -
Worel Nina,
Böhm Alexandra,
Rabitsch Werner,
Leitner Gerda,
Mitterbauer Margit,
Kalhs Peter,
Mayr Wolfgang R.,
Schwartz Dieter,
Greinix Hildegard T.
Publication year - 2012
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2011.03457.x
Subject(s) - abo blood group system , medicine , hematopoietic stem cell transplantation , transplantation , serology , gastroenterology , stem cell , immunology , surgery , antibody , biology , genetics
BACKGROUND: Due to the fact that the ABO and D system is inherited independently from the HLA system, approximately 40% of allogeneic hematopoietic stem cell transplants (HSCT) are performed across the blood group barrier. Reports on the development of de novo anti‐D in patients undergoing reduced‐intensity conditioning (RIC) followed by D‐mismatched allogeneic HSCT are rare. The objective of this study was to evaluate the frequency of anti‐D alloimmunization after D‐mismatched HSCT following RIC and its prognostic impact on transplant outcome. STUDY DESIGN AND METHODS: Forty patients with hematologic diseases who underwent D‐mismatched HSCT were retrospectively analyzed: 19 D− patients with a D+ donor and 21 D+ patients with a D− donor. Routine serologic testing for blood group typing and antibody screening was performed by a column agglutination method every time when transfusion of red blood cell units was requested and in the posttransplantation course to demonstrate establishment of donor ABO type and to detect alloimmunization. RESULTS: After a median serologic follow‐up of 21 (range, 0 to 73) months after HSCT, anti‐D was identified in 2 of 21 (10%) D+ patients receiving a D− transplant, 23 and 34 months after HSCT. None of the 19 D− patients with a D+ donor developed an anti‐D. CONCLUSION: We observed an infrequent de novo anti‐D formation that is more likely in D+ recipients of D− grafts. However, the development of anti‐D does not normally impair the transplant outcome and is not of clinical relevance in the posttransplant course.