title: ABO incompatibility is associated with increased non-relapse and GVHD related mortality in patients with malignancies treated with a reduced intensity regimen: a single center experience of 221 patients.
abstract: The effect of ABO-incompatibility on transplantation outcome remains a controversial issue, with many of the reported studies showing conflicting results. In this study, we evaluate: the association between ABO-incompatibility and myeloid engraftment; the incidence and severity of acute and chronic graft-versus-host disease (GVHD); non-relapse mortality (NRM); GVHD-associated mortality, relapse and overall survival (OS). Our study includes 221 patients with malignant diseases treated in the same institution with the same reduced intensity regimen. Other variables known to affect the transplantation outcome such as age, disease, disease risk, and donor characteristics were well-balanced between ABO-matched and ABO-mismatched transplants. Analysis of our data shows increased incidence of NRM during the first months after transplantation in the groups of patients with major and minor ABO-incompatibility. Although neither incidence nor severity of GVHD differed significantly among the different groups, we found increased mortality associated with GVHD in the major ABO-incompatible groups. Long-term OS and relapse rate were not different, although we observed a trend for decreased OS during the first year post transplantation in the group of patients with major ABO-incompatibility. Our study showed that ABO-incompatibility has an adverse impact on the transplantation outcome.
authors.affiliation: Department of BMT and Cancer Immunotherapy, Hadassah Hebrew University Medical Center, Jerusalem, Israel. gashka@hadassah.org.il
authors.forename: Igor B
authors.initials: IB
authors.lastname: Resnick
authors.forename: Panagiotis D
authors.initials: PD
authors.lastname: Tsirigotis
authors.forename: Michael Y
authors.initials: MY
authors.lastname: Shapira
authors.forename: Memet
authors.initials: M
authors.lastname: Aker
authors.forename: Menachem
authors.initials: M
authors.lastname: Bitan
authors.forename: Simcha
authors.initials: S
authors.lastname: Samuel
authors.forename: Ali
authors.initials: A
authors.lastname: Abdul-Hai
authors.forename: Aliza
authors.initials: A
authors.lastname: Ackerstein
authors.forename: Reuven
authors.initials: R
authors.lastname: Or
authors.forename: Shimon
authors.initials: S
authors.lastname: Slavin
mesh_terms: D000017:ABO Blood-Group System; D000328:Adult; D000368:Aged; D001787:Blood Group Incompatibility; D005260:Female; D006086:Graft vs Host Disease / Q000401:mortality / Q000503:physiopathology*; D006801:Humans; D007938:Leukemia / Q000628:therapy; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000628:therapy; D009369:Neoplasms / Q000628:therapy*; D012008:Recurrence; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000379:methods*
chemical_list: D000017:ABO Blood-Group System