The influence of blood group differences in allogeneic hematopoietic peripheral blood progenitor cell transplantation.
BACKGROUND
Severe immunohematologic complications after ABO-mismatched allogeneic blood peripheral blood progenitor cell (PBPC) transplantation (PBPCT), including pure red cell aplasia and immune hemolysis, have been described. Although several studies have addressed this issue, the clinical influence of blood group differences on transfusion requirements and survival is still discussed controversially, especially in the case of PBPCT.


METHODS
This single-center study is based on 143 patients receiving PBPCT after standard or reduced-intensity conditioning. The influence of blood group differences in the ABO, Rh, and Kell systems on red blood cell, platelet, and plasma transfusion requirements; length of hospitalization in transplantation unit; survival; and occurrence of graft-versus-host disease was investigated. Additionally, the influence of the conditioning regimen and irregular antibodies on the measures mentioned above was analyzed.


RESULTS
Multivariate analysis demonstrated that minor and bidirectional ABO mismatch (p = 0.028) and Rh difference (p = 0.020) independently led to poorer survival. The Kell difference did not show significant influences on the measures mentioned above. A clinically relevant influence of blood group differences on transfusion requirements could not be demonstrated. Irregular antibodies also did not show significant influences.


CONCLUSIONS
These findings indicate an influence of blood group differences in PBPCT on survival and must be studied in further detail.
Erker
Christian G
CG
Institute for Transfusion Medicine, University Hospital of Muenster, Muenster, Germany.
Steins
Martin B
MB
Fischer
Rudolf-Josef
RJ
Kienast
Joachim
J
Berdel
Wolfgang E
WE
Sibrowski
Walter
W
Cassens
Uwe
U
D000017:ABO Blood-Group System / Q000276:immunology; D000293:Adolescent; D000328:Adult; D000368:Aged; D001789:Blood Group Antigens / Q000097:blood* / Q000276:immunology; D001803:Blood Transfusion; D002423:Cause of Death; D005260:Female; D006801:Humans; D007518:Isoantibodies / Q000097:blood; D007902:Length of Stay; D007938:Leukemia / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D012008:Recurrence
D000017:ABO Blood-Group System; D001789:Blood Group Antigens; D007518:Isoantibodies