ABO-incompatible Allogeneic Peripheral Blood Stem Cell Transplantation And Transfusion

Objective: To explore the hematopoietic reconstitution and the selection of blood component transfusion for patients undergoing ABO-incom-patible allogeneic peripheral blood stem cell transplantation(allo-PBSCT). Methods: 9 cases were performed between ABO incompatible siblings among 30 cases HLA-matched allo-PBSCTS. out of these 9 cases, 6 cases were major ABO-incompatiblity and 3 cases were minor ABO-incompatiblity. ABO blood group and serum agglutinin were identified in recipients and donors before transplantion. The amount of PBSC was controlled under 200ml for minor ABO-mismatched and major plus minor ABO-mismatched. The amount of red blood cell in peripheral blood stem cell (PBSC) was controlled under 10 ml during the harvest of mononuc-leocyte for major ABO-mismatched. The other procedures were performed according to general rules. The conversion of blood group and the level serum agglutinin of the recipients were examined at different intervals after transplantation to guide the transfusion.The time for stem cell engraftment was compared with that of the patients undergoing ABO compatible transplantation. Results: The time for hematopoietic reconstitution was observed by three stands [WBC≥ 1.0 × 109/L, PLT≥20× 109/L (without transfusion) and engraftment], The result showed that the time for stem cell engraftment was not signigicantly different between patients undergoing ABO compatible and incompatible transplantation.The direct evidence to support stem cell engraftment was blood group transversion, The chromosomes of 7 cases were invaribly transformed into donor-type, among these 9 cases PBSCTS. None of the patients had hemolytic reaction during the infusion of PBSC and transfusion after transplanta- tion. Conclusion: The effect of the ABO blood group incompatiblity on hematopoietic reconstitution in allo-PBSCT was not significant. The infusion of PBSC with red blood cells controlled under 10ml could prevent hemolytic reaction. The blood component transfusion chosed ac- cording to the conversion of blood type and the level of serum agglutinin of recipients after transplantation could prevent hemolytic reaction and did not affect the time for stem cell engraftment and blood type conver- sion.