Abstract Number: PB1049
Meeting: ISTH 2021 Congress
Theme: Vascular Biology » Stem Cells and Vascular Cell Growth
Background: Allogeneic hematopoietic stem cell transplantation (alloHSCT) is a curative treatment for a variety of hematological diseases. The impact of ABO incompatibility on the clinical outcome after HSCT has been argued and it has been found to have no negative impact on it.
Aims: To investigate the complications and outcome associated with ABO compatible & incompatible transplants.
Methods: A retrospective, single-center, cohort study was conducted at our center. Patients were categorized according to ABO compatibility and incompatibility.Laboratory parameters and clinical details were recorded.
Results: A total of 107 patients were recruited, out of which 100 (93.45%) had allogenic transplants whereas 7 (6.8%) patients underwent autologous transplants. Among them 68 (63.5%) were male and 32 (30%) were female, with a median age of 9.5 years (IQR=12.75). Full-match related transplants were 69 (69%) as opposed to haploidentical which were 31 (31%). Comparison of demographics in ABO compatible and incompatible transplant groups is presented in Table1. Post-transplant outcomes are presented in Table 2. Significant consequences observed were pure red cell aplasia in 4 (4%) i.e. (p=0.0161) patients, whereas gut GVHD in 10 (10%) patients i.e. (p=0.000) in both groups. Mortality was reported in 17 (17.7%) patients; thus, the overall survival curve of 83 (83%) patients from the day of transplant to day +100 was found to be insignificant i.e. (p=0.377). Moreover, in the post-transplantation period, the significant mean rank of platelet transfusions was 55.15 in the matched group, while 43.23 mean rank in the mismatched group i.e. (p=0.045). Chimerism between the groups was also not significantly different.
| SALIENT FEATURES OF DEMOGRAPHIC CHARACTERISTICS |
COMPATIBILE Matched group (n=61) |
INCOMPATIBILE (n=39) Mismatched group 39(40.62) |
|||
| n= 61 (59.2%) |
MAJOR n=16 (41.0%) |
MINOR n=15 (42.9%) |
BIDIRECTIONAL n=08 (20.5%) |
||
| AGE | Age <18 | 47(64.4) | 11(15.1) | 11(15.1) | 4(5.5) |
| 18-40 | 13(50) | 5(19.2) | 4(15.4) | 4(15.4) | |
| >40 | 1(100) | – | – | – | |
| Most Common Indications of Transplant | Beta thalassemia major (%) | 28(66.7) | 5(11.9) | 6(14.3) | 3(7.1) |
| Aplastic anemia (%) | 26(63.4) | 8(19.5) | 3(7.3) | 4(9.8) | |
| Source of stem cell | Bone Marrow (n=40) | 24(60) | 4(9.8) | 9(22.0) | 3(7.3) |
| Peripheral Marrow (n=59) | 36(61) | 12(20.7) | 6(10.3) | 5(8.6) | |
| BM +PM (n=1) | 1(100) | – | – | – | |
Comparison of Demographics in ABO Compatible and Incompatible
| Outcomes | Matched | Major | Minor | Bidirectional | P-Value | |||
| Graft Failure | Primary GF (n=13) | 8(72.7) | 3(27.3) | – | – | 0.251 | ||
| Secondary GF (n=12) | 5(71.4) | 1(14.3) | 1(14.3) | – | 0.861 | |||
| Acute GVHD (Graft Versus Host Disease) | Skin (%) | 4(80) | 1(20) | – | – | 0.922 | ||
| Gut (%) | 8(80) | – | 1(10) | 1(10) | 0.000* | |||
| Ocular (%) | 2(100) | – | – | – | 0.804 | |||
| Liver (%) | 4(57.1) | 1(14.3) | 1(14.3) | 1(14.3) | 0.523 | |||
| Oral (%) | 9(81.8) | 1(9.1) | – | 1(9.1) | 0.291 | |||
| Complications | PRCA | – | 2(50) | – | 2(50) | 0.016* | ||
| CMV | 13(65) | 3(15) | 4(20) | – | 0.495 | |||
Post transplant outcomes of Matched and Mismatched group
Conclusions: ABO incompatibility does not seem to influence the parameters in patients undergoing allogeneic stem cell transplantation. Hence, careful monitoring of patients can help early detection and treat them efficiently by reducing the number of life threatening events.
To cite this abstract in AMA style:
Borhany M, Zaidi U, Abid M, Zafar S, Shamsi T. Impact of ABO Incompatibility on the Outcome of Hematopoeitic Stem Cell Transplantation [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/impact-of-abo-incompatibility-on-the-outcome-of-hematopoeitic-stem-cell-transplantation/. Accessed September 24, 2021.« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/impact-of-abo-incompatibility-on-the-outcome-of-hematopoeitic-stem-cell-transplantation/