title: IgM anti-recipient ABO antibodies predict acute graft-versus-host disease following allogeneic hematopoietic stem cell transplantation.
abstract: Passenger lymphocyte syndrome (PLS) presents as transient immune hemolysis due to anti-recipient ABO antibodies produced by donor B-lymphocytes accompanying minor or bidirectional ABO incompatible allogeneic hematopoietic stem cell transplantation (HSCT). We monitored both IgM and IgG type anti-recipient ABO antibodies in 18 consecutive HSCT recipients with hematological malignancies. Five of these patients (28%) developed transient immune hemolysis due to PLS after a median of 19 days post-HSCT. This response was associated with the detection of IgM and IgG anti-recipient ABO antibodies after a median of 16 and 22 days post-HSCT, respectively. All five patients subsequently developed acute graft-versus-host disease (GVHD) grades II-IV, and three died due to transplant-related mortality (TRM) within 1 year after HSCT, while in contrast, of the 13 patients without PLS, three (23%) developed grades II-IV acute GVHD (p < 0.01) and the 1-year TRM was 8% (p = 0.03). Thus, patients with PLS had a significantly lower 1-year overall survival than those without PLS (20 vs. 75%, p = 0.03). These findings suggest that the IgM anti-recipient ABO antibody may be an early predictor of acute GVHD and poor survival after minor or bidirectional ABO incompatible HSCT.
authors: Department of Hematology and Oncology, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa 920-8641, Japan. zaimokuyoshitaka@gmail.com
authors: Yoshitaka
authors: Y
authors: Zaimoku
authors: Akiyoshi
authors: A
authors: Takami
authors: Hidehiro
authors: H
authors: Sato
authors: Maki
authors: M
authors: Utsumi
authors: Shinji
authors: S
authors: Nakao
mesh_terms: D000017:ABO Blood-Group System / Q000737:chemistry*; D000293:Adolescent; D000328:Adult; D000744:Anemia, Hemolytic, Autoimmune / Q000209:etiology*; D001323:Autoantibodies / Q000032:analysis*; D001787:Blood Group Incompatibility / Q000097:blood / Q000276:immunology*; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000097:blood / Q000453:epidemiology / Q000276:immunology / Q000503:physiopathology*; D019337:Hematologic Neoplasms / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis*; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D000017:ABO Blood-Group System; D001323:Autoantibodies; D007075:Immunoglobulin M
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