供受者ABO血型不合对单份非血缘脐血造血干细胞移植早期疗效的影响

OBJECTIVE: To retrospectively study the impacts of ABO incompatibility on early outcome after single unit unrelated cord blood transplantation (UCBT), such as cumulative incidence of engraftment, incidence of acute graft-versus-host disease (aGVHD) and 180-day transplant-related mortality (TRM). METHODS: 208 patients underwent single unit UCBT from April 2008 to October 2014 were analyzed, included 99 ABO-identical, 60 minor, 38 major and 11 bidirectional ABO-incompatible recipients. All the patients received intensified myeloablative conditioning, and a combination of cyclosporine A and mycophenolate mofetil was given for GVHD prophylaxis. RESULTS: Cumulative incidences of neutrophil engraftment, platelet recovery, erythroid lineage reconstitution, Ⅱ-Ⅳ aGVHD, Ⅲ-Ⅳ aGVHD and 180-day TRM showed no significant difference among the patients receiving ABO-identical, minor, major, and bidirectional UCBT (all P>0.05, respectively). What's more, none of the patients developed pure red-cell aplasia (PRCA) after UCBT. Group A donor and a group O recipient patients didn't appeared to influence the clinical results when compared with others (all P>0.05, respectively). CONCLUSION: Patients receive ABO-incompatible UCBT may not develop PRCA. The presence of ABO-incompatibility did not influence the hematopoietic reconstitution, the incidence of aGVHD and 180-day TRM in this cohort. There is not support for the need to regard ABO-compatibility as an UCB-graft selection criterion.