TY - JOUR
T1 - The impact of ABO compatibility on allogeneic hematopoietic cell transplantation outcomes
T2 - a contemporary and comprehensive study from the transplant complications working party of the EBMT
AU - Guven, Mustafa
AU - Peczynski, Christophe
AU - Boreland, William
AU - Blaise, Didier
AU - Peffault de Latour, Regis
AU - Yakoub-Agha, Ibrahim
AU - Gedde-Dahl, Tobias
AU - Salmenniemi, Urpu
AU - Forcade, Edouard
AU - Passweg, Jakob
AU - Chevallier, Patrice
AU - Sandrine, Loron
AU - Mielke, Stephan
AU - Broers, Annoek
AU - Ceballos, Patrice
AU - Byrne, Jennifer
AU - Castilla-Llorente, Cristina
AU - Maertens, Johan
AU - Huynh, Anne
AU - Cerretti, Raffaella
AU - Bulabois, Claude Eric
AU - van Gorkom, Gwendolyn
AU - Crawley, Charles
AU - Graham, Charlotte
AU - Mussetti, Alberto
AU - Schoemans, Helene
AU - Penack, Olaf
AU - Moiseev, Ivan
AU - Peric, Zinaida
PY - 2025/4/1
Y1 - 2025/4/1
N2 - The role of ABO blood group system mismatch on allogeneic hematopoietic cell transplantation (allo-HCT) outcomes is controversial since current publications of large datasets are lacking. We retrospectively analyzed 30,487 patients transplanted between 2010 and 2021 using the EBMT registry to assess ABO incompatibility's effect on non-relapse mortality (NRM), overall survival (OS), progression-free survival (PFS), relapse incidence (RI), acute GvHD (aGvHD), chronic GvHD (cGvHD), and neutrophil engraftment. Transplantations were classified as ABO-compatible (56.3%), major (18.1%), minor (20.1%), and bidirectional (5.5%) incompatibilities. Mainly peripheral blood stem cells (PBSC) were used as the cell source in 85.6% of cases. Multivariate analysis found no significant association between compatibility status, with the compatible group serving as the reference, and NRM, OS, PFS, RI or cGvHD. The incidence of non-engraftment was significantly higher in the major (HR 1.04, 95% CI 1.01-1.07, p = 0.021) and bidirectional (HR 1.09, 95% CI 1.03-1.15, p = 0.003) incompatibilities. At the same time, the risk of severe aGvHD grades III-IV was lower in the major incompatibility group (HR 0.85, 95% CI 0.77-0.94, p = 0.001). Our large contemporary study, showing no major impact on outcomes, suggests that the ABO blood group system should not be a primary consideration in donor selection for PBSC-based allo-HCT.
AB - The role of ABO blood group system mismatch on allogeneic hematopoietic cell transplantation (allo-HCT) outcomes is controversial since current publications of large datasets are lacking. We retrospectively analyzed 30,487 patients transplanted between 2010 and 2021 using the EBMT registry to assess ABO incompatibility's effect on non-relapse mortality (NRM), overall survival (OS), progression-free survival (PFS), relapse incidence (RI), acute GvHD (aGvHD), chronic GvHD (cGvHD), and neutrophil engraftment. Transplantations were classified as ABO-compatible (56.3%), major (18.1%), minor (20.1%), and bidirectional (5.5%) incompatibilities. Mainly peripheral blood stem cells (PBSC) were used as the cell source in 85.6% of cases. Multivariate analysis found no significant association between compatibility status, with the compatible group serving as the reference, and NRM, OS, PFS, RI or cGvHD. The incidence of non-engraftment was significantly higher in the major (HR 1.04, 95% CI 1.01-1.07, p = 0.021) and bidirectional (HR 1.09, 95% CI 1.03-1.15, p = 0.003) incompatibilities. At the same time, the risk of severe aGvHD grades III-IV was lower in the major incompatibility group (HR 0.85, 95% CI 0.77-0.94, p = 0.001). Our large contemporary study, showing no major impact on outcomes, suggests that the ABO blood group system should not be a primary consideration in donor selection for PBSC-based allo-HCT.
KW - BONE-MARROW
KW - DONOR
KW - INCOMPATIBILITY
KW - MISMATCH
KW - RECIPIENTS
KW - SURVIVAL
U2 - 10.1038/s41409-025-02580-8
DO - 10.1038/s41409-025-02580-8
M3 - Article
SN - 0268-3369
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
M1 - 102597
ER -