title: Is ABO mismatch another risk factor for allogeneic hematopoietic stem cell transplantation in pediatric thalassemic patients?
abstract: The ABO incompatibility between donor and recipient is not considered a barrier to successful allogeneic HSCT. Nevertheless, conflicting data still exist about the influence of ABO incompatibility on transplant outcome in pediatric patients with thalassemia. Fifty-one children with beta-thalassemia major who underwent allogeneic HSCT were enrolled this study. Twenty-three of them (45%) received an ABO-incompatible transplant [minor ABO mismatch: six (26%), major ABO mismatch: fourteen (61%), and bidirectional mismatch: three (13%)]. In this study, ABO incompatibility did not significantly impair GVHD, VOD, neutrophil and platelet engraftment, TRM, OS and TFS. Particularly in major and bidirectional ABO-mismatched patients, a delayed erythroid recovery was recorded as compared to the group receiving an ABO-compatible graft (median time, 31 and 38 days vs. 19.5 days; p: 0.02 and p: 0.03). Median time to red cell transfusion independence was significantly longer in major ABO-incompatible patients (median time, 87 days vs. 32 days; p: 0.001). Therefore, whenever feasible, major ABO-mismatched donors should be avoided in HSCT recipients, to prevent delayed erythroid recovery with prolonged RBC transfusion needs and impaired quality of life.
authors.affiliation: Department of Pediatric Hematology/Oncology & Bone Marrow Transplantation Unit, Faculty of Medicine, Atakent Hospital, Acıbadem University, Istanbul, Turkey.
authors.forename: Didem
authors.initials: D
authors.lastname: Atay
authors.affiliation: Department of Pediatric Hematology/Oncology & Bone Marrow Transplantation Unit, Faculty of Medicine, Atakent Hospital, Acıbadem University, Istanbul, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Erbey
authors.affiliation: Department of Pediatric Hematology/Oncology & Bone Marrow Transplantation Unit, Faculty of Medicine, Atakent Hospital, Acıbadem University, Istanbul, Turkey.
authors.forename: Arzu
authors.initials: A
authors.lastname: Akcay
authors.affiliation: Department of Pediatric Hematology/Oncology & Bone Marrow Transplantation Unit, Faculty of Medicine, Atakent Hospital, Acıbadem University, Istanbul, Turkey.
authors.forename: Gulyuz
authors.initials: G
authors.lastname: Ozturk
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000293:Adolescent; D001787:Blood Group Incompatibility / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D006086:Graft vs Host Disease / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011182:Postoperative Care / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D014184:Transplantation, Homologous / Q000379:methods; D016896:Treatment Outcome; D017086:beta-Thalassemia / Q000276:immunology / Q000401:mortality / Q000628:therapy*
chemical_list: D000017:ABO Blood-Group System
keywords: ABO incompatibility; hematopoietic recovery; pediatric patients with thalassemia; transfusion needs