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ABO Compatibility

Transplantation of ABO-incompatible bone marrow and peripheral blood stem cell components

Abstract

Hemolysis may occur during infusion of an ABO-incompatible HSC component if the recipient has isoagglutinins directed against donor red blood cells, or later as a result of the production by donor lymphocytes of isoagglutinins directed against recipient ABO-antigens. Peripheral blood stem cell (PBSC) components collected by apheresis contain few red cells but considerably greater numbers of lymphocytes than marrow. We reviewed the transplant courses of 158 recipients of marrow (n = 90) or PBSC (n = 68) from HLA-identical, ABO-incompatible sibling donors. No patient experienced immediate or delayed hemolysis attributable to the ABO incompatibility. Recipients of minor ABO-incompatible red cell-replete marrow required fewer red cell transfusions during the first week after transplantation than recipients of PBSC or marrows depleted of red cells; the red cell transfusion requirements for the following 3 weeks did not differ. The maximum level of bilirubin did not differ for patients classified by ABO incompatibility or source of HSC. The development of positive antiglobulin tests occurred for eight marrow recipients from a separate group of 22 patients (17 marrow, five PBSC) for whom this testing was performed. None of these patients developed overt hemolysis. These data indicate that hemolysis complicating ABO-incompatible transplantation is not common after either marrow or PBSC transplantation. Bone Marrow Transplantation (2000) 26, 749–757.

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Acknowledgements

We wish to acknowledge the staffs of the Transfusion Office, Apheresis Unit, Clinical Cryobiology Laboratory, and the inpatient and outpatient transplant wards of the Fred Hutchinson Cancer Research Center for their role in the management of patients undergoing ABO-incompatible hematopoietic stem cell transplantation. Funding for this project was provided in part by grant numbers CA18029 and CA15704 from the National Cancer Institute, Bethesda, MD.

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Rowley, S., Liang, P. & Ulz, L. Transplantation of ABO-incompatible bone marrow and peripheral blood stem cell components. Bone Marrow Transplant 26, 749–757 (2000). https://doi.org/10.1038/sj.bmt.1702572

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  • DOI: https://doi.org/10.1038/sj.bmt.1702572

Keywords

  • transplantation
  • hematopoietic stem cell
  • bone marrow
  • peripheral blood stem cell
  • ABO incompatibility
  • isoagglutinin

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