Donor‐type red blood cell transfusion to deplete isoagglutinins prior to allogeneic stem cell transplantation from ABO major incompatible bone marrow donors

Summary ABO incompatibility affects approximately 40% of allogeneic stem cell transplants in Caucasian patient populations. Because bone marrow (BM), the preferred graft from paediatric sibling donors and for non‐malignant diseases, has a red blood cell (RBC) content similar to blood, anti‐donor iso...

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Bibliographic Details
Published in:British journal of haematology 2023-06, Vol.201 (6), p.1159-1168
Main Authors: Jarisch, Andrea, Salzmann‐Manrique, Emilia, Soerensen, Jan, Sach, Gudrun, Rettinger, Eva, Willasch, Andre, Bakhtiar, Shahrzad, Klarmann, Dieter, Bräuninger, Susanne, Moser, Laura, Fekadu, Julia, Hutter, Martin, Klingebiel, Thomas, Klusmann, Jan‐Henning, Bader, Peter, Bonig, Halvard
Format: Article
Language:English
Subjects:
ABO Blood-Group System
ABO mismatch
ABO system
Allografts
alloHSCT
Blood
Blood Group Incompatibility
Blood transfusion
Bone Marrow
Bone marrow transplantation
Bone Marrow Transplantation - adverse effects
Child
donor‐type red blood cell transfusion
Erythrocyte Transfusion - adverse effects
Erythrocytes
Hematology
Hematopoietic Stem Cell Transplantation - adverse effects
Humans
paediatric transplantation
recipient isoagglutinins
Red-Cell Aplasia, Pure - etiology
Retrospective Studies
Stem cell transplantation
Stem cells
Transplants & implants
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Summary:Summary ABO incompatibility affects approximately 40% of allogeneic stem cell transplants in Caucasian patient populations. Because bone marrow (BM), the preferred graft from paediatric sibling donors and for non‐malignant diseases, has a red blood cell (RBC) content similar to blood, anti‐donor isoagglutinins must either be depleted from the recipient or RBCs removed from the graft. To achieve tolerability of unmanipulated BM grafts, we used controlled infusions of donor ABO‐type RBC units to deplete isoagglutinins before the transplant. This retrospective study evaluates the outcomes of 52 ABO major incompatible BM transplants performed at our centre between 2007 and 2019. The use of donor‐type RBC transfusions was well tolerated. They effectively reduced isoagglutinins levels, typically achieving target titres after one (60%) or two (29%) transfusions. The approach allowed for successful and uneventful infusions of unmanipulated BM which provided timely engraftment. The transplant outcomes were not inferior to those of a matched‐pair control group of patients with ABO‐identical donors.
ISSN:0007-1048
1365-2141
DOI:10.1111/bjh.18761