title: Frequency and prognostic value of D alloantibodies after D-mismatched allogeneic hematopoietic stem cell transplantation after reduced-intensity conditioning.
abstract: BACKGROUND
  Due to the fact that the ABO and D system is inherited independently from the HLA system, approximately 40% of allogeneic hematopoietic stem cell transplants (HSCT) are performed across the blood group barrier. Reports on the development of de novo anti-D in patients undergoing reduced-intensity conditioning (RIC) followed by D-mismatched allogeneic HSCT are rare. The objective of this study was to evaluate the frequency of anti-D alloimmunization after D-mismatched HSCT following RIC and its prognostic impact on transplant outcome.
  
  
  METHODS
  Forty patients with hematologic diseases who underwent D-mismatched HSCT were retrospectively analyzed: 19 D- patients with a D+ donor and 21 D+ patients with a D- donor. Routine serologic testing for blood group typing and antibody screening was performed by a column agglutination method every time when transfusion of red blood cell units was requested and in the posttransplantation course to demonstrate establishment of donor ABO type and to detect alloimmunization.
  
  
  RESULTS
  After a median serologic follow-up of 21 (range, 0 to 73) months after HSCT, anti-D was identified in 2 of 21 (10%) D+ patients receiving a D- transplant, 23 and 34 months after HSCT. None of the 19 D- patients with a D+ donor developed an anti-D.
  
  
  CONCLUSIONS
  We observed an infrequent de novo anti-D formation that is more likely in D+ recipients of D- grafts. However, the development of anti-D does not normally impair the transplant outcome and is not of clinical relevance in the posttransplant course.
authors: Department for Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria. nina.worel@meduniwien.ac.at
authors: Nina
authors: N
authors: Worel
authors: Alexandra
authors: A
authors: Böhm
authors: Werner
authors: W
authors: Rabitsch
authors: Gerda
authors: G
authors: Leitner
authors: Margit
authors: M
authors: Mitterbauer
authors: Peter
authors: P
authors: Kalhs
authors: Wolfgang R
authors: WR
authors: Mayr
authors: Dieter
authors: D
authors: Schwartz
authors: Hildegard T
authors: HT
authors: Greinix
mesh_terms: D000017:ABO Blood-Group System / Q000097:blood / Q000276:immunology; D000328:Adult; D001787:Blood Group Incompatibility / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D001788:Blood Grouping and Crossmatching; D005260:Female; D006086:Graft vs Host Disease / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D007518:Isoantibodies / Q000032:analysis* / Q000097:blood; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018029:Rho(D) Immune Globulin; D016036:Seroepidemiologic Studies; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods*; D014184:Transplantation, Homologous
chemical_list: D000017:ABO Blood-Group System; D007518:Isoantibodies; C061961:RHO(D) antibody; D018029:Rho(D) Immune Globulin