Pilar Solves Alcaina*
Department of Hematology and Hemotherapy, Hospital Universitario I Politécnico La Fe, SpainFulltext PDF
Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) is a treatment modality for highrisk hematological malignancies that has considerably evolved over time. ABO incompatibility (major, minor or both) has never been considered as a contraindication for HSCT, since ABO antigens are not expressed in the hematopoietic stem cells. In fact, near 40% to 50 % of all HSCT has some degree of ABO incompatibility and ABO mismatch does not have relevant impact on transplantation outcome. Some known immuno hematologic complications arising after transplantation are related to hematic and seric ABO group changes in ABO incompatible HSCT. Pure Red Blood Cell Aplasia (PRCA) occurs in major incompatibility and is due to unexpected persistence of recipient isoagglutinins directed against donor Red Blood Cell (RBC) antigen long time after HSCT. Passenger lymphocyte syndrome occurs in minor incompatibility and is explained by an immune but transient response by the donor lymphocytes producing isoagglutinins against recipient RBCs. On the contrary, if isoagglutinins are directed to ABO antigens absent in donor and recipient RBCs, hemolytic complications do not occur. Little information is available about the isoagglutinin evolution after different HSCT modalities and in some cases contradictory results are reported. The objective of this article is to update the knowledge regarding the donor and recipient isoagglutinin titers kinetics after ABO incompatible HSCT and review the clinical conditions that can be associated.
Alcaina PS. A Review of Isoagglutinin Change Kinetics in ABO Incompatible Hematopoietic Stem Cell Transplantation. Ann Stem Cell Res Ther. 2018; 2(4): 1025.