Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Cord Blood Stem Cells

Impact of ABO-mismatch on risk of GVHD after umbilical cord blood transplantation

Bone Marrow Transplantation volume 48, pages 1046–1049 (2013)Cite this article

Subjects

Abstract

Recent advances in allogeneic hematopoietic cell transplant (allo-HCT) have led to an increasing use of alternative donors, including banked umbilical cord blood (UCB). Despite these advances, acute GVHD (aGVHD) and chronic GVHD (cGVHD) continue to be the leading causes of early and late transplant-related mortality. ABO-mismatch has been frequently reported as a risk factor for GVHD, however, data in the UCB recipients are limited. We hypothesized that as the lymphocytes in the cord blood are thought to be naive, they will therefore be less likely to mediate GVHD. Therefore, we analyzed the impact of ABO-mismatch on aGVHD and cGVHD in recipients of single and double UCB-HCT. In both univariate and multivariate analyses, presence of ABO-mismatch did not have an impact on aGVHD or cGVHD. Whereas ABO-compatible donors are preferred in recipients of URD-HCT, ABO compatibility generally need not be considered in recipients of UCB-HCT.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Eiz-Vesper B, Seltsam A, Blasczyk R . ABO glycosyltransferases as potential source of minor histocompatibility antigens in allogeneic peripheral blood progenitor cell transplantation. Transfusion 2005; 45: 960–968.

    Article  CAS  PubMed  Google Scholar 

  2. Klumpp TR . Immunohematologic complications of bone marrow transplantation. Bone Marrow Transplant 1991; 8: 159–170.

    CAS  PubMed  Google Scholar 

  3. Keever-Taylor CA, Bredeson C, Loberiza FR, Casper JT, Lawton C, Rizzo D et al. Analysis of risk factors for the development of GVHD after T cell-depleted allogeneic BMT: effect of HLA disparity, ABO incompatibility, and method of T-cell depletion. Biol Blood Marrow Transplant 2001; 7: 620–630.

    Article  CAS  PubMed  Google Scholar 

  4. Stussi G, Muntwyler J, Passweg JR, Seebach L, Schanz U, Gmur J et al. Consequences of ABO incompatibility in allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 2002; 30: 87–93.

    Article  CAS  PubMed  Google Scholar 

  5. Seebach JD, Stussi G, Passweg JR, Loberiza FR, Gajewski JL, Keating A et al. ABO blood group barrier in allogeneic bone marrow transplantation revisited. Biol Blood Marrow Transplant 2005; 11: 1006–1013.

    Article  PubMed  Google Scholar 

  6. Ludajic K, Balavarca Y, Bickeboller H, Rosenmayr A, Fischer GF, Fae I et al. Minor ABO-mismatches are risk factors for acute graft-versus-host disease in hematopoietic stem cell transplant patients. Biol Blood Marrow Transplant 2009; 15: 1400–1406.

    Article  PubMed  Google Scholar 

  7. Mielcarek M, Leisenring W, Torok-Storb B, Storb R . Graft-versus-host disease and donor-directed hemagglutinin titers after ABO-mismatched related and unrelated marrow allografts: evidence for a graft-versus-plasma cell effect. Blood 2000; 96: 1150–1156.

    CAS  PubMed  Google Scholar 

  8. Goldman J, Liesveld J, Nichols D, Heal J, Blumberg N . ABO incompatibility between donor and recipient and clinical outcomes in allogeneic stem cell transplantation. Leuk Res 2003; 27: 489–491.

    Article  PubMed  Google Scholar 

  9. Klumpp TR, Herman JH, Ulicny J, Emmons RV, Martin ME, Mangan KF . Lack of effect of donor-recipient ABO mismatching on outcome following allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 2006; 38: 615–620.

    Article  CAS  PubMed  Google Scholar 

  10. Resnick IB, Tsirigotis PD, Shapira MY, Aker M, Bitan M, Samuel S et al. ABO incompatibility is associated with increased non-relapse and GVHD related mortality in patients with malignancies treated with a reduced intensity regimen: a single center experience of 221 patients. Biol Blood Marrow Transplant 2008; 14: 409–417.

    Article  CAS  PubMed  Google Scholar 

  11. Blin N, Traineau R, Houssin S, Peffault de Latour R, Petropoulou A, Robin M et al. Impact of donor-recipient major ABO mismatch on allogeneic transplantation outcome according to stem cell source. Biol Blood Marrow Transplant 2010; 16: 1315–1323.

    Article  PubMed  Google Scholar 

  12. Wang Z, Sorror ML, Leisenring W, Schoch G, Maloney DG, Sandmaier BM et al. The impact of donor type and ABO incompatibility on transfusion requirements after nonmyeloablative haematopoietic cell transplantation. Br J Haematol 2010; 149: 101–110.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Arcese W, Rocha V, Labopin M, Sanz G, Iori AP, de Lima M et al. Unrelated cord blood transplants in adults with hematologic malignancies. Haematologica 2006; 91: 223–230.

    PubMed  Google Scholar 

  14. Berglund S, Le Blanc K, Remberger M, Gertow J, Uzunel M, Svenberg P et al. Factors with an impact on chimerism development and long-term survival after umbilical cord blood transplantation. Transplantation 2012; 94: 1066–1074.

    Article  PubMed  Google Scholar 

  15. Przepiorka D, Weisdorf D, Martin P, Klingemann HG, Beatty P, Hows J et al1994 Consensus conference on acute gvhd grading. Bone Marrow Transplant 1995; 15: 825–828.

    Google Scholar 

  16. Filipovich AH, Weisdorf D, Pavletic S, Socie G, Wingard JR, Lee SJ et al. National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report. Biol Blood Marrow Transplant 2005; 11: 945–956.

    Article  PubMed  Google Scholar 

  17. Gooley TA, Leisenring W, Crowley J, Storer BE . Estimation of failure probabilities in the presence of competing risks: new representations of old estimators. Stat Med 1999; 18: 695–706.

    Article  CAS  PubMed  Google Scholar 

  18. Kaplan EL, Meier P . Nonparametric estimation from incomplete observation. J Am Stat Assoc 1958; 53: 457–481.

    Article  Google Scholar 

  19. Cox DR . Regression models and life tables. J R Stat Soc B 1972; 34: 187–220.

    Google Scholar 

  20. MacMillan ML, Weisdorf DJ, Brunstein CG, Cao Q, DeFor TE, Verneris MR et al. Acute graft-versus-host disease after unrelated donor umbilical cord blood transplantation: analysis of risk factors. Blood 2009; 113: 2410–2415.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Verneris MR, Brunstein CG, Barker J, MacMillan ML, DeFor T, McKenna DH et al. Relapse risk after umbilical cord blood transplantation: enhanced graft-versus-leukemia effect in recipients of 2 units. Blood 2009; 114: 4293–4299.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Medicine, Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, MN, USA

    R Romee, D J Weisdorf, C Brunstein, Q Cao, N S Majhail, G M Vercellotti, J S Miller & M Arora

  2. Pediatrics, Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, MN, USA

    J E Wagner & B R Blazar

Authors
  1. R Romee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D J Weisdorf
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C Brunstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J E Wagner
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Q Cao
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. B R Blazar
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. N S Majhail
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. G M Vercellotti
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. J S Miller
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. M Arora
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M Arora.

Ethics declarations

Competing interests

The authors declare no conflict of interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Romee, R., Weisdorf, D., Brunstein, C. et al. Impact of ABO-mismatch on risk of GVHD after umbilical cord blood transplantation. Bone Marrow Transplant 48, 1046–1049 (2013). https://doi.org/10.1038/bmt.2013.8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2013.8

Keywords

This article is cited by

Search

Advanced search

Quick links