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ABO blood type incompatibility lost the unfavorable impact on outcome in unrelated bone marrow transplantation

Bone Marrow Transplantation volume 54, pages 1676–1685 (2019)Cite this article

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Abstract

The effects of ABO incompatibility on hematopoietic stem cell transplantation remain controversial. Large cohorts are required to obtain findings that allow for definite conclusions. We previously demonstrated poor overall survival and increased treatment-related mortality (TRM) in ABO-incompatible unrelated bone marrow transplantation (UR-BMT) performed during the period from 1993 to 2005. To improve our understanding of ABO-incompatible transplantation, we reanalyzed the effects of ABO mismatch in a UR-BMT cohort in Japan after 2000. Multivariate analyses for the 2000–2006 cohort showed that major ABO mismatch was associated with poor overall survival (HR, 1.211; 95% CI, 1.062 to 1.381; p = 0.004) and increased TRM (HR, 1.357; 95% CI, 1.146 to 1.608; p < 0.001). In the 2007–2015 cohort, major incompatibility had no effect on overall survival (HR, 0.987, p = 0.804) or TRM (HR, 1.020, p = 0.790). Delayed engraftment of erythrocytes, platelets, and neutrophils in cases of major mismatch was common between the two cohorts. In conclusion, the adverse effect of ABO major incompatibility has become less significant over time.

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Acknowledgements

This work was supported in part by the Practical Research Project for Allergic Diseases and Immunology (Research Technology of Medical Transplantation) from Japan Agency for Medical Research and Development, AMED under Grant Number 18ek0510023h0002. The authors thank all of the physicians and data managers at the centers that contributed valuable data on transplantation to the Japan Society for Hematopoietic Cell Transplantation and the Japan Marrow Donor Program.

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Authors and Affiliations

  1. Division of hematology, National Defence Medical College, Tokorozawa, Japan

    Fumihiko Kimura

  2. Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Junya Kanda

  3. Department of Hematology and Oncology, Kanazawa University Hospital, Kanazawa, Japan

    Ken Ishiyama

  4. Japanese Red Cross Kanto-koshinetsu block blood center, Tokyo, Japan

    Toshio Yabe

  5. Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan

    Kota Yoshifuji

  6. Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan

    Takahiro Fukuda

  7. Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    Yukiyasu Ozawa

  8. Department of Hematology, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima, Japan

    Koji Iwato

  9. Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan

    Tetsuya Eto

  10. Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan

    Takehiko Mori

  11. Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan

    Naoyuki Uchida

  12. Department of Gastroenterology and Hematology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Shuichi Ota

  13. Division of Hematology, Saiseikai Maebashi Hospital, Maebashi, Japan

    Toru Sakura

  14. Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan

    Tatsuo Ichinohe

  15. Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan

    Yoshiko Atsuta

  16. Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Yoshiko Atsuta

  17. Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan

    Yoshinobu Kanda

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  1. Fumihiko Kimura
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  16. Yoshinobu Kanda
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for the donor/source working group of the Japan Society for Hematopoietic Cell Transplantation

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Correspondence to Fumihiko Kimura.

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Kimura, F., Kanda, J., Ishiyama, K. et al. ABO blood type incompatibility lost the unfavorable impact on outcome in unrelated bone marrow transplantation. Bone Marrow Transplant 54, 1676–1685 (2019). https://doi.org/10.1038/s41409-019-0496-2

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