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May 22, 2021 article Open access Aachen paper

Selective ABO immunoadsorption in hematopoietic stem cell transplantation with major ABO incompatibility

European Journal Of Haematology, vol. 107, pp. 324–332

DOI: 10.1111/ejh.13668 Full text (OA) OpenAlex

Abstract

OBJECTIVE: ABO mismatch between donor and recipient occurs in 40% of allogeneic hematopoietic stem cell transplantations (HCT). Different strategies have been described to reduce isohemagglutinins (IHA) before HCT. We describe the effect of selective ABO immunoadsorption (ABO IA) on erythrocyte transfusion rate and the development of post-transplant pure red cell aplasia (ptPRCA). METHODS: 63 patients with major ABO incompatibility were retrospectively analyzed. Nine patients with major ABO incompatibility and high-IHA titer were treated by ABO IA before HCT. We analyzed the need for transfusion and the occurrence of ptPRCA. We compared the outcome with patients treated by other methods to reduce IHA. RESULTS: In all nine patients treated by ABO IA, IHA decreased in a median four times. PtPRCA occurred in one patient. The median number of transfusions was 8 (range: 0-36) between d0 and d100. In 25 patients with high-IHA titer without treatment or treated by other methods to reduce IHA, the need for transfusions was comparable. No difference in the incidence of ptPRCA was observed. CONCLUSIONS: Selective ABO IA is a feasible, safe, and effective method to reduce IHA before HCT in major ABO incompatibility. No effect on transfusion rate or ptPRCA compared to other strategies could be observed.

Authors 15

  1. Martina Margrit Crysandt Aachen Department of Hematology, Oncology Hemostaseology and Stem Cell Transplantation Medical Faculty Medical Faculty

    RWTH Aachen University

    Affiliation as printed

    Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) Aachen Germany

    Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation Medical Faculty RWTH Aachen University Aachen Germany

    Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Aachen, Germany

    Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany

  2. Hatice Soysal Aachen Department of Hematology, Oncology Hemostaseology and Stem Cell Transplantation Medical Faculty Medical Faculty

    RWTH Aachen University

    Affiliation as printed

    Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) Aachen Germany

    Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation Medical Faculty RWTH Aachen University Aachen Germany

    Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Aachen, Germany

    Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany

  3. Eva Jennes Aachen Department of Hematology, Oncology Hemostaseology and Stem Cell Transplantation Medical Faculty Medical Faculty

    RWTH Aachen University

    Affiliation as printed

    Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation Medical Faculty RWTH Aachen University Aachen Germany

    Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany

  4. Udo Holtick

    University of Cologne · University Hospital Cologne

    Affiliation as printed

    Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) Aachen Germany

    Department I of Internal Medicine Medical Faculty and University Hospital University of Cologne Cologne Germany

    Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Aachen, Germany

    Department I of Internal Medicine, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany

  5. Matthias Mrotzek

    University of Cologne · University Hospital Cologne

    Affiliation as printed

    Institute of Transfusion Medicine Medical Faculty and University Hospital University of Cologne Cologne Germany

    Institute of Transfusion Medicine, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany

  6. Susanne Rehnelt

    University of Bonn · University Hospital Bonn

    Affiliation as printed

    Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) Aachen Germany

    Department of Oncology, Hematology, Immuno‐Oncology and Rheumatology University Hospital Bonn Bonn Germany

    Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Aachen, Germany

    Department of Oncology, Hematology, Immuno-Oncology and Rheumatology, University Hospital Bonn, Bonn, Germany

  7. Tobias A.W. Holderried

    University of Bonn · University Hospital Bonn

    Affiliation as printed

    Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) Aachen Germany

    Department of Oncology, Hematology, Immuno‐Oncology and Rheumatology University Hospital Bonn Bonn Germany

    Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Aachen, Germany

    Department of Oncology, Hematology, Immuno-Oncology and Rheumatology, University Hospital Bonn, Bonn, Germany

  8. Martina Wessiepe Aachen Division of Transfusion Medicine Medical Faculty Division of Transfusion Medicine Medical Faculty

    RWTH Aachen University

    Affiliation as printed

    Division of Transfusion Medicine Medical Faculty RWTH Aachen University Aachen Germany

    Division of Transfusion Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany

  9. Uta Kunter Aachen Department of Nephrology and Clinical Immunology Medical Faculty Department of Nephrology and Clinical Immunology Medical Faculty

    RWTH Aachen University

    Affiliation as printed

    Department of Nephrology and Clinical Immunology Medical Faculty RWTH Aachen University Aachen Germany

    Department of Nephrology and Clinical Immunology, Medical Faculty, RWTH Aachen University, Aachen, Germany

  10. Stefan Wilop
    Affiliation as printed

    MVZ West GmbH Würselen Hämatologie‐Onkologie Würselen Germany

  11. Gerda Silling Aachen Department of Hematology, Oncology Hemostaseology and Stem Cell Transplantation Medical Faculty Medical Faculty

    RWTH Aachen University

    Affiliation as printed

    Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) Aachen Germany

    Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation Medical Faculty RWTH Aachen University Aachen Germany

    Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Aachen, Germany

    Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany

  12. Judith Gecht Aachen Department of Hematology, Oncology Hemostaseology and Stem Cell Transplantation Medical Faculty Medical Faculty

    RWTH Aachen University

    Affiliation as printed

    Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) Aachen Germany

    Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation Medical Faculty RWTH Aachen University Aachen Germany

    Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Aachen, Germany

    Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany

  13. Fabian Beier Aachen Department of Hematology, Oncology Hemostaseology and Stem Cell Transplantation Medical Faculty Medical Faculty

    RWTH Aachen University

    Affiliation as printed

    Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) Aachen Germany

    Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation Medical Faculty RWTH Aachen University Aachen Germany

    Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Aachen, Germany

    Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany

  14. Tim H. Brümmendorf Aachen Department of Hematology, Oncology Hemostaseology and Stem Cell Transplantation Medical Faculty Medical Faculty

    RWTH Aachen University

    Affiliation as printed

    Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) Aachen Germany

    Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation Medical Faculty RWTH Aachen University Aachen Germany

    Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Aachen, Germany

    Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany

  15. Edgar Jost corresponding Aachen Department of Hematology, Oncology Hemostaseology and Stem Cell Transplantation Medical Faculty Medical Faculty

    RWTH Aachen University

    Affiliation as printed

    Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) Aachen Germany

    Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation Medical Faculty RWTH Aachen University Aachen Germany

    Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Aachen, Germany

    Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany

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References 42