ABO血型不合异基因造血干细胞移植与红系造血重建

目的:探讨ABO血型不合对异基因造血干细胞移植(allo-HSCT)患者造血重建,特别是红系造血重建的影响.方法:回顾分析了4例ABO主要不合和8例ABO次要不合的HLA相合的allo-HSCT患者造血恢复情况,着重观察了这两组病人移植后溶血现象、血型转变时间、输注红细胞量以及血红蛋白恢复情况来比较分析其红系造血重建.结果:12例ABO血型不合的allo-HSCT受者在输入造血干细胞悬液时无1例发生急性溶血和输血相关性溶血,主要不合和次要不合对allo-HSCT骨髓植活和血小板恢复均无影响,但主要不合组红系恢复有延迟的趋势,有1例发生迟发性溶血.结论:供受者ABO血型主要不合可能影响红系的造血重建.

A Retrospective Study on ABO-incompatible Allogeneic Hematopoietic Stem Cell Transplantation and Hematopoietic Reconstitution

Objective:To study the effects of ABO-incompatibility on the hematopoietic reconstitution,particularly the erythropoiesis reconstitution,in HLA-matched allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods: A retrospective study was performed among 12 HLA-matched allo-HSCT subjects composing 4 major ABO-incompatible and 8 minor ABO-incompatible cases.Hematopoietic reconstitution in these subjects was analyzed in terms of post-transplantation hemolysis,time to blood group transversion,units of RBC transfused and recovery of hemoglobin.Results: None of 12 recipients developed acute transfusion related hemolysis during infusion of stem cells.Both major and minor ABO incompatibility had no adverse effects on engraftment and recovery of platelets.However,the major ABO-incompatible group showed trends of slower erythropoietic recovery and 1 recipient in this group experienced delayed hemolysis.Conclusion: The major ABO incompatibility may affect erythropoiesis reconstitution in HLA-matched allo-HSCT.