Contributions
Abstract: PB2481
Type: Publication Only
Background
Though ABO incompatibility is not a contraindication for BMT, it can be a factor responsible for lower overall survival.
Aims
We present our data on ABO incompatible transplants and their outcomes.
Methods
Of the 87 BMT’s done at our centre, 14 were ABO incompatible. The indications for BMT were malignancies like refractory AML or relapsed B ALL and benign haematological conditions like Aplastic Anaemia and Thalassemia Major. Among the ABO incompatible BMTs, 9 were major incompatibility, 5 were minor. For all major and bidirectional blood group incompatibility, we determined the recipient antibody titres, and in all cases where the recipient isoagglutinin titre was more than 1:64, repeated plasma exchange was done till antibody titres were less than 1:16. IVIG in a dose of 0.5 gm/kg was also given to the recipient on Day -1. Red cell depletion of the graft by centrifugation was also undertaken in all cases of major ABO incompatibility.
Results
One patient with major ABO incompatibility had a severe haemolytic reaction following infusion of bone marrow stem cells and transplant had to be aborted. The baseline isoagglutinin level was 1;64 and repeat plasma depletion of the patient was done to reduce the isoagglutinin levels to below 1:4. Peripheral blood stem cells were harvested from the donor which was red cell depleted by centrifugation and this was infused without incident.
None of the other cases had any immediate or delayed haemolytic reaction. However 1 patient subsequently died due to graft failure and 2 from sepsis.
Conclusion
In our series, ABO incompatibility did not seem to have been a major factor behind poor outcome. The mortality in our limited series is possibly due to the aggressive nature of the primary disease like refractory AML and patient condition rather than blood group mismatch per se.
Session topic: 23. Stem cell transplantation - Clinical
Keyword(s): ABO blood group
Abstract: PB2481
Type: Publication Only
Background
Though ABO incompatibility is not a contraindication for BMT, it can be a factor responsible for lower overall survival.
Aims
We present our data on ABO incompatible transplants and their outcomes.
Methods
Of the 87 BMT’s done at our centre, 14 were ABO incompatible. The indications for BMT were malignancies like refractory AML or relapsed B ALL and benign haematological conditions like Aplastic Anaemia and Thalassemia Major. Among the ABO incompatible BMTs, 9 were major incompatibility, 5 were minor. For all major and bidirectional blood group incompatibility, we determined the recipient antibody titres, and in all cases where the recipient isoagglutinin titre was more than 1:64, repeated plasma exchange was done till antibody titres were less than 1:16. IVIG in a dose of 0.5 gm/kg was also given to the recipient on Day -1. Red cell depletion of the graft by centrifugation was also undertaken in all cases of major ABO incompatibility.
Results
One patient with major ABO incompatibility had a severe haemolytic reaction following infusion of bone marrow stem cells and transplant had to be aborted. The baseline isoagglutinin level was 1;64 and repeat plasma depletion of the patient was done to reduce the isoagglutinin levels to below 1:4. Peripheral blood stem cells were harvested from the donor which was red cell depleted by centrifugation and this was infused without incident.
None of the other cases had any immediate or delayed haemolytic reaction. However 1 patient subsequently died due to graft failure and 2 from sepsis.
Conclusion
In our series, ABO incompatibility did not seem to have been a major factor behind poor outcome. The mortality in our limited series is possibly due to the aggressive nature of the primary disease like refractory AML and patient condition rather than blood group mismatch per se.
Session topic: 23. Stem cell transplantation - Clinical
Keyword(s): ABO blood group