Prevalence of Pure Red Cell Aplasia Following Major ABO-Incompatible Hematopoietic Stem Cell Transplantation
| Autor: | Panpan Zhu, Yibo Wu, Dawei Cui, Jimin Shi, Jian Yu, Yanmin Zhao, Xiaoyu Lai, Lizhen Liu, Jue Xie, He Huang, Yi Luo |
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| Rok vydání: | 2021 |
| Předmět: |
haploidentical donor
Immunology Hematopoietic Stem Cell Transplantation RC581-607 urologic and male genital diseases Red-Cell Aplasia Pure isohemagglutinin ABO Blood-Group System allogeneic hematologic stem cell transplantation major ABO-incompatible transplantation surgical procedures operative pure red cell aplasia hemic and lymphatic diseases Case-Control Studies Prevalence Immunology and Allergy Humans Prospective Studies Immunologic diseases. Allergy |
| Zdroj: | Frontiers in Immunology, Vol 13 (2022) |
| ISSN: | 1664-3224 |
| Popis: | BackgroundPure red cell aplasia (PRCA) is one of the important complications in major ABO-incompatible allogeneic hematopoietic stem cell transplantation (HSCT). The established pathogenic factor of PRCA is the persistence of high anti-donor isohemagglutinins. As previously verified, the conditioning regimen and donor type were the factors associated with the development of PRCA in the small-sized studies. Currently, the prevalence, risk factors, and prognosis of PRCA are still worth studying to provide evidence.MethodsWe conducted a prospective nested case-control study to determine the prevalence, donor-related factors, and the outcomes of PRCA following major ABO-incompatible transplantation. A total of 469 patients who underwent ABO-incompatible grafts were observed.ResultsNone of the patients were diagnosed with PRCA with minor or bidirectional ABO-incompatible HSCT. Thirteen of the187 patients (7%; 95% confidence interval [CI], 3.9%–11.9%) developed PRCA following major ABO-incompatible HSCT. Eleven of the 13 patients with PRCA recovered entirely. Donor type was an independent factor associated with post-HSCT PRCA (odds ratio [OR]=0.030; 95% CI, 0.003–0.321; P=0.004). The cumulative incidence rates of post-HSCT PRCA in the context of major ABO-incompatible HSCT were 0.8%, 13.1%, and 27.2% for the haploidentical donor (HID), unrelated donor, and matched related donor, respectively. No significant influence of PRCA on transplantation outcomes was observed.In conclusion, post-HSCT PRCA is a rare and less threatening complication in major ABO-incompatible HSCT. The majority of patients with PRCA could recover. Additionally, HIDs for recipients may have a low risk of post-HSCT PRCA. This trial was registered at www.chictr.org.cn (#ChiCTR2000041412). |
| Databáze: | OpenAIRE |
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