title: ABO mismatch increases transplant-related morbidity and mortality in patients given nonmyeloablative allogeneic HPC transplantation.
abstract: BACKGROUND
  ABO mismatch has not been thought to affect the outcome of patients undergoing myeloablative conditioning and allogeneic HPC transplantation. Data on transplant-related complications after ABO-mismatched transplantation after nonmyeloablative conditioning are limited.
  
  
  METHODS
  Therefore, 40 patients were analyzed after nonmyeloablative conditioning with regard to ABO compatibility. Eleven received a minor and bidirectional and 8 a major ABO-mismatched graft.
  
  
  RESULTS
  Four patients had evidence of hemolysis during engraftment, being lethal in one, and three developed pure RBC aplasia. Six patients in the ABO-mismatched group developed thrombotic microangiopathy, and three of them died. ABO-identical and ABO-mismatched patients had a similar incidence of GVHD. Viral infections occurred in both groups in equal shares. Patients with an ABO-mismatch had to be rehospitalized until Day 100 for a median of 19 days versus 0 days in the identical group (p < 0.05). Overall survival was 60 and 57 percent in the ABO-identical and ABO-mismatch groups, respectively. The probability of transplant-related mortality was 0 versus 28 percent in the identical group compared to patients with an ABO mismatch (p < 0.05). The probability of relapse or progression was 76 versus 25 percent in the ABO-identical group compared to the ABO-mismatched group, respectively.
  
  
  CONCLUSIONS
  Significantly more patients with ABO mismatch showed transplant-associated complications and died as a result of transplant-related causes.
authors.affiliation: Department for Blood Group Serology and Transfusion Medicine, University of Vienna, Vienna, Austria. nina.worel@univie.ac.at
authors.forename: Nina
authors.initials: N
authors.lastname: Worel
authors.forename: Peter
authors.initials: P
authors.lastname: Kalhs
authors.forename: Felix
authors.initials: F
authors.lastname: Keil
authors.forename: Erika
authors.initials: E
authors.lastname: Prinz
authors.forename: Karin
authors.initials: K
authors.lastname: Moser
authors.forename: Axel
authors.initials: A
authors.lastname: Schulenburg
authors.forename: Margit
authors.initials: M
authors.lastname: Mitterbauer
authors.forename: Christine
authors.initials: C
authors.lastname: Mannhalter
authors.forename: Wolfgang R
authors.initials: WR
authors.lastname: Mayr
authors.forename: Ilse
authors.initials: I
authors.lastname: Schwarzinger
authors.forename: Paul
authors.initials: P
authors.lastname: Höcker
authors.forename: Klaus
authors.initials: K
authors.lastname: Lechner
authors.forename: Hildegard T
authors.initials: HT
authors.lastname: Greinix
mesh_terms: D000017:ABO Blood-Group System; D000328:Adult; D000368:Aged; D001787:Blood Group Incompatibility / Q000150:complications*; D002493:Central Nervous System Diseases / Q000209:etiology; D018450:Disease Progression; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D006402:Hematologic Diseases / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000401:mortality*; D006760:Hospitalization; D006801:Humans; D007154:Immune System Diseases / Q000209:etiology; D007239:Infections / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016019:Survival Analysis; D014184:Transplantation, Homologous
chemical_list: D000017:ABO Blood-Group System