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Adverse Occurrence type:
Common, as HLA matching is the primary criteria for donor selection
Time to detection:
13-35 days post transplant in this case series
Alerting signals, symptoms, evidence of occurrence:
Delayed red cell and platelet engraftment, red cell aplasia, increased transfusion support
Demonstration of imputability or root cause:
In patients that underwent bidirectional or major ABO mismatch transplantation, there was increased transfusion need, delayed red cell and platelet engraftment, red cell aplasia and increased severity of acute GVHD. This was associated with higher non-relapse mortality and shortened disease free survival and overall survival in the setting of reduced intensity hematopoietic cell transplantation.
ABO blood group incompatibility as an adverse risk factor for outcomes in patients with myelodysplastic syndromes and acute myeloid leukemia undergoing HLA-matched peripheral blood hematopoietic cell transplantation after reduced-intensity conditioning. TRANSFUSION 2016;56;518–527
Expert comments for publication:
This publication highlights the importance of ABO incompatibility in recipients receiving allo-hematopoietic stem cell transplantation especially in the setting of reduced intensity conditioning.