| Major ABO-incompatible BMT: isohemagglutinin reduction with plasma exchange is safe and avoids graft manipulation. | |
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MedLine Citation:
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PMID: 23334277 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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The impact of donor-recipient ABO incompatibility on long-term BMT outcomes remains controversial. A common strategy is to deplete the donor marrow of red cells, although this variably reduces the number of CD34+ cells. This 10-year retrospective study assessed the impact of recipient plasma exchange in major ABO-incompatible allogeneic BMT on outcomes and survival. Target Ab titres were1:4 for anti-A and1:8 for anti-B. Patients with higher titres underwent plasma exchange before marrow infusion. Of 133 patients who underwent allogeneic BMT, 34 had a major ABO-incompatible donor. The median number of exchanges was 2 (range 1-4). There were no acute haemolytic transfusion reactions. Engraftment times, transfusion requirements and acute and chronic GVHD were no different from those of patients with an ABO-identical donor. Treatment-related mortality at 100 days was 21% in the group with a major ABO-incompatible donor and 17% in the group with an identical donor (P=0.8). Plasma exchange of the recipient is a safe method of managing donor-recipient major ABO incompatibility before BMT without the risk of haematopoietic progenitor cell loss associated with red cell depletion of the graft.Bone Marrow Transplantation advance online publication, 21 January 2013; doi:10.1038/bmt.2012.264. |
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Authors:
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D Sheppard; J Tay; A Bryant; S McDiarmid; L Huebsch; M Tokessy; L Hamelin; E Saidenberg; C Bredeson |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2013-1-21 |
Journal Detail:
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Title: Bone marrow transplantation Volume: - ISSN: 1476-5365 ISO Abbreviation: Bone Marrow Transplant. Publication Date: 2013 Jan |
Date Detail:
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Created Date: 2013-1-21 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8702459 Medline TA: Bone Marrow Transplant Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Division of Hematology, Department of Medicine, Blood and Marrow Transplant Program, The Ottawa Hospital, Ottawa, Ontario, Canada. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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