АВ0-INCOMPATIBILITY IN ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION: 15-YEARS EXPERIENCE OF R.M. GORBACHEVA MEMORIAL RESEARCH INSTITUTE FOR CHILDREN ONCOLOGY, HEMATOLOGY AND TRANSPLANTATION

Introduction. AB0-incompatibility in different types of allogeneic hematopoietic stem cell transplantation (HSCT) may be an additional aggravating factor for the development of immunological complications and decrease treatment efficacy.

Materials and methods. From May 1999 to December 2015 in R.M. Gorbacheva Memorial Research Institute for Children Oncology, Hematology and Transplantation 1131 patients with malignancies and hereditary diseases were included to the study, which were performed 1428 allogeneic HSCT: allogeneic unrelated – 814 (57.0 %), allogeneic related – 344 (24.1 %), haploidentical – 267 (18.7 %), umbilical cord blood in 3 patients (0.2 %). Age was 0–76 years, median – 25 years.

Results. In 54.6 % of cases (n = 780) АВ0-incompatibility was determined: major – 37.8 % (n = 295); minor – 45.4 % (n = 354); combined – 16.8 % (n = 131). АВ0-incompatibility in allogeneic HSCT did not influence overall survival (p = 0.56), frequency of acute graftversus-host disease (GVHD) (p = 0.2). There was an increased frequency of acute GVHD in combination with reduced intensity conditioning regimens and АВ0-incompatibility (30.8 %) compared with myeloablative regimens (15.3 %; p = 0.002).

1. Афанасьев Б.В., Зубаровская Л.С., Моисеев И.С. Аллогенная трансплантация гемопоэтических стволовых клеток у детей: настоящее, проблемы, перспективы. Российский журнал детской гематологии и онкологии 2015;2(2):28–42. [Afanas’ev B.V., Zubarovskaya L.S., Moiseev I.S. Allogeneic hematopoietic stem cell transplantation in children: now, problems and prospects. Rossiyskiy zhurnal detskoy gematologii i onkologii = Russian Journal of Children Hematology and Oncology 2015;2(2):28–42. (In Russ.)]. DOI: 10.17650/2311-1267-2015-2-2-28-42.

2. Passweg J.R., Baldomero H., Bader P. et al. Hematopoietic SCT in Europe 2013: recent trends in the use of alternative donors showing more haploidentical donors but fewer cord blood transplants. Bone Marrow Transplant 2015;50(4):476–82. DOI: 10.1038/bmt.2014.312. PMID: 25642761.

3. Rowley S.D., Donato M.L., Bhattacharyya P. Red blood cell-incompatible allogeneic hematopoietic progenitor cell transplantation. Bone Marrow Transplant 2011;46(9):1167–85. DOI: 10.1038/bmt.2011.135. PMID: 21897398.

4. Worel N. AB0-mismatched allogeneic hematopoietic stem cell transplantation. Transfus Med Hemother 2016;43(1):3–12. DOI: 10.1159/000441507. PMID: 27022317.

5. Seebach J.D., Stussi G., Passweg J.R. et al. ABO blood group barrier in allogeneic bone marrow transplantation revisited. Biol Blood Marrow Transplant 2005;11(12):1006–13. DOI: 10.1016/j.bbmt.2005.07.015. PMID: 16338623.

6. Worel N., Greinix H.T., Schneider B. et al. Regeneration of erythropoiesis after relatedand unrelated-donor BMT or peripheral blood HPC transplantation: a major ABO mismatch means problems. Transfusion 2000;40(5):543–50. PMID: 10827256.

7. Ahmed I., Teruya J., Murray-Krezan C., Krance R. The incidence of autoimmune hemolytic anemia in pediatric hematopoietic stem cell recipients post-first and post-second hematopoietic stem cell transplant. Pediatr Transplant 2015;19(4):391–8. DOI: 10.1111/petr.12455. PMID: 25809012.

8. Kimura F., Sato K., Kobayashi S. et al. Impact of AB0-blood group incompatibility on the outcome of recipients of bone marrow transplants from unrelated donors in the Japan Marrow Donor Program. Haematologica 2008;93(11):1686–93. DOI: 10.3324/haematol.12933. PMID: 18835834.

9. Remberger M., Watz E., Ringden O. et al. Major ABO blood group mismatch increases the risk for graft failure after unrelated donor hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2007;13(6):675–82. DOI: 10.1016/j.bbmt.2007.01.084. PMID: 17531777.

10. Jagasia M., Arora M., Flowers M.E. et al. Risk factors for acute GVHD and survival after hematopoietic cell transplantation. Blood 2012;119(1):296–307. DOI: 10.1182/blood-2011-06-364265. PMID: 22010102.

11. Inamoto Y., Storer B.E., Petersdorf E.W. et al. Incidence, risk factors, and outcomes of sclerosis in patients with chronic graft-versushost disease. Blood 2013;121(25):5098–103. DOI: 10.1182/blood-2012-10-464198. PMID: 23547053.

12. Atay D., Erbey F., Akcay A., Ozturk G. Is ABO mismatch another risk factor for allogeneic hematopoietic stem cell transplantation in pediatric thalassemic patients? Pediatr Transplant 2015;19(6):645–51. DOI: 10.1111/petr.12552. PMID: 26156679.

13. Gutiérrez-Aguirre C.H., Gómez-De-León A., Alatorre-Ricardo J. et al. Allogeneic peripheral blood stem cell transplantation using reduced-intensity conditioning in an outpatient setting in ABO-incompatible patients: are survival and graft-versus-host disease different? Transfusion 2014;54(5): 1269–77. DOI: 10.1111/trf.12466. PMID: 24898453.

14. Worel N., Kalhs P. AB0-incompatible allogeneic hematopoietic stem cell transplantation. Haematologica 2008;93(11):1605–7. DOI: 10.3324/haematol.2008.001057. PMID: 18978296.

15. Национальное гематологическое общество. Клинические рекомендации по диагностике и лечению острых миелоидных лейкозов взрослых. II Конгресс гематологов России, 2014. [The National Society of Hematology. Clinical guidelines for the diagnosis and treatment of acute myeloid leukemia of adults. II Congress of Russian Hematologists, 2014. (In Russ.)].

16. Przepiorka D., Weisdorf D., Martin P. et al. 1994 Consensus Conference on Acute GVHD Grading. Bone Marrow Transplant 1995;15(6):825–8. PMID: 7581076.

17. Booth G.S., Gehrie E.A., Bolan C.D., Savani B.N. Clinical guide to ABО-incompatible allogeneic stem cell transplantation. Biol Blood Marrow Transplant 2013;19(8):1152–8. DOI: 10.1016/j.bbmt.2013.03.018. PMID: 23571461.

18. Michallet M., Le Q.H., Mohty M. et al. Predictive factors for outcomes after reduced intensity conditioning hematopoietic stem cell transplantation for hematological malignancies: a 10-year retrospective analysis from the Société Française de Greffe de Moelle et de Thérapie Cellulaire. Exp Hematol 2008;36(5):535–44. DOI: 10.1016/j.exphem.2008.01.017. PMID: 18346838.

19. Goldman J., Liesveld J., Nichols D. et al. ABО incompatibility between donor and recipient and clinical outcomes in allogeneic stem cell transplantation. Leuk Res 2003;27(6):489–91. PMID: 12648507.

20. Gehrie E.A., Cates J.M., Nian H. et al. Blood group A antigen expression on cardiac endothelium is highly individualized: possible implications for transplantation. Cardiovasc Pathol 2013;22(4):251–6. DOI: 10.1016/j.carpath.2012.10.007. PMID: 23290353.