title: Impact of Graft-Recipient ABO Compatibility on Outcomes after Umbilical Cord Blood Transplant for Nonmalignant Disease.
abstract: Existing literature shows mixed conclusions regarding the impact of ABO incompatibility on outcomes after hematopoietic stem cell transplantation. Because the future for umbilical cord blood (UCB) expansion technologies is bright, we assessed whether this typically overlooked graft characteristic impacted various outcomes after UCB transplantation (UCBT) for nonmalignant disorders (NMDs). A prospectively maintained institutional blood and marrow transplant program database was queried for all patients undergoing first UCBT for NMDs. UCB and recipient ABO compatibility was considered as matched, major mismatched, minor mismatched, or bidirectional mismatched. The impact of ABO incompatibility was assessed on overall survival, graft failure, acute and chronic graft-versus-host disease (GVHD), time to neutrophil and platelet recovery, day 0 to day 100 RBC transfusion burden, and donor hematopoietic chimerism. Through December 2014, 270 patients have undergone first UCBT for various NMDs. In both univariable and multivariable analyses, ABO compatibility status did not appear to impact any outcomes assessed, although a trend toward increased grades III to IV acute GVHD was seen in recipients of major mismatched units. When considering UCBT for treatment of NMDs, ABO compatibility between the donor unit and intended recipient does not appear to be an important consideration in the UCB unit choice.
authors: Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota. Electronic address: kudek011@umn.edu.
authors: Matthew R
authors: MR
authors: Kudek
authors: Biostatistics and Bioinformatics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.
authors: Ryan
authors: R
authors: Shanley
authors: Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota.
authors: Nicole D
authors: ND
authors: Zantek
authors: Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota.
authors: David H
authors: DH
authors: McKenna
authors: Division of Pediatric Blood and Marrow Transplantation, University of Minnesota, Minneapolis, Minnesota.
authors: Angela R
authors: AR
authors: Smith
authors: Division of Pediatric Blood and Marrow Transplantation, University of Minnesota, Minneapolis, Minnesota.
authors: Weston P
authors: WP
authors: Miller
mesh_terms: D000017:ABO Blood-Group System; D001787:Blood Group Incompatibility / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000209:etiology; D006801:Humans; D008297:Male; D016896:Treatment Outcome
chemical_list: D000017:ABO Blood-Group System
keywords: Alternative donor transplant; Graft–recipient ABO compatibility; Nonmalignant disorders; Umbilical cord blood transplant