title: Minor ABO-mismatches are risk factors for acute graft-versus-host disease in hematopoietic stem cell transplant patients.
abstract: We investigated the impact of ABO and Rhesus (Rh) blood group matching on the outcome of hematopoietic stem cell transplantation (HSCT) of 154 patients matched at 10/10 HLA loci with unrelated donors. ABO and Rh, as potential risk factors, were modeled with the clinical outcome--acute and chronic graft-versus-host disease (aGVHD, cGVHD), relapse, treatment-related mortality (TRM), and overall survival (OS)--by simple, multiple, and competing risk analyses. We found that minor ABO-mismatches represent a significant risk factor for aGVHD (II-IV) with an estimated risk increase of almost 3-fold (hazard ratio [HR]=2.92, 95% confidence interval [CI]: 1.43-5.95, P=.003), and even 4-fold for aGVHD (III-IV) (HR=4.24, 95% CI: 1.70-10.56, P=.002), but not for other transplant endpoints. No significant association of the Rh matching status with any of the HSCT endpoints was seen. These results suggest that ABO minor mismatches may play a role in aGvHD pathophysiology, possibly by providing the setting for T cell activation and antibody mediated damage. To decrease the risk of aGVHD, ABO matching should be considered in HSCT.
authors.affiliation: Division of Blood Group Serology, Medical University of Vienna, Austria.
authors.forename: Katarina
authors.initials: K
authors.lastname: Ludajic
authors.forename: Yesilda
authors.initials: Y
authors.lastname: Balavarca
authors.forename: Heike
authors.initials: H
authors.lastname: Bickeböller
authors.forename: Agathe
authors.initials: A
authors.lastname: Rosenmayr
authors.forename: Gottfried F
authors.initials: GF
authors.lastname: Fischer
authors.forename: Ingrid
authors.initials: I
authors.lastname: Faé
authors.forename: Peter
authors.initials: P
authors.lastname: Kalhs
authors.forename: David
authors.initials: D
authors.lastname: Pohlreich
authors.forename: Michal
authors.initials: M
authors.lastname: Kouba
authors.forename: Marie
authors.initials: M
authors.lastname: Dobrovolna
authors.forename: Hildegard T
authors.initials: HT
authors.lastname: Greinix
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000293:Adolescent; D000328:Adult; D001787:Blood Group Incompatibility / Q000150:complications*; D001855:Bone Marrow Diseases / Q000601:surgery; D005260:Female; D006086:Graft vs Host Disease / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology; D006680:HLA Antigens / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007938:Leukemia / Q000601:surgery; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012204:Rh-Hr Blood-Group System / Q000276:immunology*; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000017:ABO Blood-Group System; D006680:HLA Antigens; D012204:Rh-Hr Blood-Group System