ABO-Mismatched Transplants

Bone Marrow Transplantation (2004) 34, 321–329. doi:10.1038/sj.bmt.1704579 Published online 5 July 2004

ABO-incompatible bone marrow transplantation: a GITMO survey of current practice in Italy and comparison with the literature

R Raimondi1, M Soli2, T Lamparelli3, A Bacigalupo3, W Arcese4, M Belloni2 and F Rodeghiero1 on behalf of the Gruppo Italiano Trapianto di Midollo Osseo (GITMO)

  1. 1Department of Haematology, BMT Unit, S Bortolo Hospital, Vicenza, Italy
  2. 2Immunohaematology and Transfusion Service, S Bortolo Hospital, Vicenza, Italy
  3. 3Department of Haematology-Oncology, BMT Unit, S Martino Hospital, Genoa, Italy
  4. 4Department of Biopathology, University Tor Vergata, Rome, Italy

Correspondence: Dr R Raimondi, Divisione di Ematologia, Ospedale S Bortolo, Via Rodolfi 37, Vicenza 36100, Italy. E-mail: raimondi@hemato.ven.it

Received 28 July 2003; Accepted 24 March 2004; Published online 5 July 2004.

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Abstract

ABO incompatibility is not considered a contraindication for allogeneic haematopoietic stem cell transplantation (HSCT) despite its association with several immunohaematological complications. At present, there is no general agreement concerning the best methods to reduce these problems. To survey current practice related to ABO-incompatible HSCT in Italy, a questionnaire was sent to all GITMO centres. Specific questions were addressed for management in pretransplant, peritransplant and post transplant phases. A comparison was made with the experience reported in the literature. In all, 74% of GITMO centres answered the questionnaire. A high degree of heterogeneity concerning the pretransplant tests, methods to overcome infusion of ABO-incompatible marrow and post transplant transfusion policy and monitoring was evident. For many of these aspects the literature does not contain unanimous guidelines. The considerable degree of heterogeneity that reflects, at least partially, the lack of consensus in the literature demonstrates that ABO incompatibility is still an open issue in the setting of HSCT and that further studies are needed for a more rationale approach and for the production of evidence-based guidelines.

Keywords:

ABO incompatibility, haematopoietic stem cell transplantation, haemolysis

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