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Is ABO mismatch another risk factor for allogeneic hematopoietic stem cell transplantation in pediatric thalassemic patients?
Author(s) -
Atay Didem,
Erbey Fatih,
Akcay Arzu,
Ozturk Gulyuz
Publication year - 2015
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12552
Subject(s) - abo blood group system , medicine , thalassemia , abo incompatibility , hematopoietic stem cell transplantation , transplantation , beta thalassemia , gastroenterology , immunology
The ABO incompatibility between donor and recipient is not considered a barrier to successful allogeneic HSCT . Nevertheless, conflicting data still exist about the influence of ABO incompatibility on transplant outcome in pediatric patients with thalassemia. Fifty‐one children with beta‐thalassemia major who underwent allogeneic HSCT were enrolled this study. Twenty‐three of them (45%) received an ABO ‐incompatible transplant [minor ABO mismatch: six (26%), major ABO mismatch: fourteen (61%), and bidirectional mismatch: three (13%)]. In this study, ABO incompatibility did not significantly impair GVHD , VOD , neutrophil and platelet engraftment, TRM , OS and TFS . Particularly in major and bidirectional ABO ‐mismatched patients, a delayed erythroid recovery was recorded as compared to the group receiving an ABO ‐compatible graft (median time, 31 and 38 days vs. 19.5 days; p: 0.02 and p: 0.03). Median time to red cell transfusion independence was significantly longer in major ABO ‐incompatible patients (median time, 87 days vs. 32 days; p: 0.001). Therefore, whenever feasible, major ABO ‐mismatched donors should be avoided in HSCT recipients, to prevent delayed erythroid recovery with prolonged RBC transfusion needs and impaired quality of life.