Clinical Impact of Recipient-Derived Isoagglutinin Levels in ABO-Incompatible Hematopoietic Stem Cell Transplantationopen access
- Authors
- Nam, Minjeong; Hur, Mina; Kim, Hanah; Lee, Tae-Hwan; Lee, Gun-Hyuk; Yoon, Sumi; Park, Seungman; Kim, Sung Yong; Lee, Mark Hong
- Issue Date
- Jan-2023
- Publisher
- MDPI AG
- Keywords
- recipient-derived isoagglutinin; hematopoietic stem cell transplantation; survival; graft-versus-host disease; RBC transfusion; platelet engraftment
- Citation
- Journal of Clinical Medicine, v.12, no.2
- Indexed
- SCIE
SCOPUS
- Journal Title
- Journal of Clinical Medicine
- Volume
- 12
- Number
- 2
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/62373
- DOI
- 10.3390/jcm12020458
- ISSN
- 2077-0383
- Abstract
- ABO incompatibility is not considered a contraindication for hematopoietic stem cell transplantation (HSCT). We hypothesized that recipient-derived isoagglutinin (RDI) levels could play a critical role in clinical outcomes. In this study, we compared clinical outcomes such as survival, GVHD, infection, relapse, transfusion, and engraftment, among ABO-compatible patients (ABOc), ABO-incompatible patients (ABOi) with low RDI, and ABOi patients with high RDI. The ABOi with high RDI group was defined as recipients with more than 1:16 RDI levels. We analyzed 103 recipients (ABOc, 53; ABOi with low RDI, 36; ABOi with high RDI, 14). The ABOi with high RDI group showed a decreased 1-year survival and increased acute GVHD grade IV and RBC transfusion (p = 0.017, 0.027, and 0.032, respectively). The ABOi with high RDI group was an independent risk factor for increased death, RBC transfusion, and poor platelet (PLT) engraftment (odds ratio (OR) = 3.20, p = 0.01; OR = 8.28, p = 0.02; OR = 0.18, p = 0.03, respectively). The ABOi with high RDI group showed significantly delayed PLT engraftment. In conclusion, this is the first study underscoring high RDI levels as a marker predicting unfavorable outcomes in ABOi HSCT.
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Collections - 2. Clinical Science > Department of Laboratory Medicine > 1. Journal Articles
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