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TRANSPLANTATION AND CELLULAR ENIGINEERING
Allogeneic peripheral blood stem cell transplantation using reduced-intensity conditioning in an outpatient setting in ABO-incompatible patients: are survival and graft-versus-host disease different?
Article first published online: 28 OCT 2013
© 2013 American Association of Blood Banks
Volume 54, Issue 5, pages 1269–1277, May 2014
How to Cite
Gutiérrez-Aguirre, C. H., Gómez-De-León, A., Alatorre-Ricardo, J., Cantú-Rodríguez, O. G., González-Llano, O., Jaime-Pérez, J. C., Mancías-Guerra, C., Flores-Jiménez, J. A. and Gómez-Almaguer, D. (2014), Allogeneic peripheral blood stem cell transplantation using reduced-intensity conditioning in an outpatient setting in ABO-incompatible patients: are survival and graft-versus-host disease different?. Transfusion, 54: 1269–1277. doi: 10.1111/trf.12466
- Issue published online: 12 MAY 2014
- Article first published online: 28 OCT 2013
- Manuscript Accepted: 12 SEP 2013
- Manuscript Revised: 9 SEP 2013
- Manuscript Received: 16 JUL 2013
Graft-versus-host disease (GVHD) is a major cause of morbimortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Minor ABO incompatibility has been associated with an increased risk of GVHD. We analyzed the impact of ABO matching on patient outcome after peripheral blood, reduced-intensity allo-HSCT in an outpatient setting, and its relationship with GVHD.
Study Design and Methods
Data of 121 patients were included. All patients received allo-HSCT from HLA-identical siblings as outpatients using a reduced-intensity conditioning regimen. Influence of ABO matching as a risk factor for the development of GVHD and survival was analyzed using logistic regression and Cox proportional hazards regression, respectively.
Median age was 36 years (range, 1-71 years); 88 patients were ABO identical: 13 presented major mismatch and 20 minor mismatch, with an ABO incompatibility rate of 27.3%. The median follow-up period was 54 months (range, 0.3-120 months). Minor ABO incompatibility patients presented the highest rate of acute GVHD (aGVHD; 25%), in comparison with ABO-identical (20.5%) and major ABO incompatibility patients (15.4%; p = 0.79). The highest incidence of chronic GVHD (cGVHD) occurred in the context of minor ABO incompatibility (35%), in contrast to ABO-identical (30.8%) and major ABO incompatibility (15.4%). Survival was higher for patients in the minor ABO mismatch group; however, there was no significant correlation between ABO matching status and survival (p = 0.45).
Using this type of peripheral blood stem cell transplantation, minor ABO-mismatched allo-HSCT was associated with a higher incidence of aGVHD and cGVHD and with increased survival, albeit with no significance.