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The Impact of ABO Incompatibility in Allogeneic Stem Cell Transplant (ALLOSCT): A Retrospective Single Center's Analysis

Track: Poster Abstracts
Saturday, March 1, 2014, 6:45 PM-7:45 PM
Longhorn Hall E (Exhibit Level 1) (Gaylord Texan)
Jan Cerny, MD, PhD , Division of Hematology/Oncology, University of Massachusetts, Worcester, MA
Muthalagu Ramanathan, MD , Hematology/Oncology Section BMT, UMASS Memorial University Campus, Worcester, MA
Glen Raffel, MD, PhD , Hematology/Oncology Section BMT, UMass Medical Center, Worcester, MA
Natasha Fortier, PAC , Hematology/Oncology - BMT, UMass Memorial Medical Center, Worcester, MA
Lindsey Shanahan, PAC , Hematology/Oncology - BMT, UMass Memorial Medical Center, Worcester, MA
Tzafra Martin, PAC , Hematology/Oncology Section BMT, UMass Memorial Medical Center, Worcester, MA
Laura Petrillo-Deluca, PAC , Hematology/Oncology, UMass Memorial Medical Center, Worcester, MA
Jayde Bednarik, PharmD , Pharmacy, UMass Memorial Medical Center, Worcester, MA
Rajneesh Nath, MD , Hematology/Oncology, Section BMT, UMass Memorial Medical Center, Worcester, MA

THE IMPACT OF ABO INCOMPATIBILITY IN ALLOGENEIC STEM CELL TRANSPLANT (ALLOSCT): A RETROSPECTIVE SINGLE CENTER'S ANALYSIS.

Cerny J, Ramanathan M, Raffel GD, Fortier N, Shanahan L, Martin T, Petrillo-Deluca L, Bednarik, and Nath R.

Background:

ABO typing is not readily available within donor databases. ABO incompatibility between donor and recipient is not considered a hurdle to an allogeneic hematopoietic stem cell transplantation (ALLOSCT). Conflicting data still exist as to its influence on graft-versus-host disease (GVHD), relapse, and survival.

Method:

We retrospectively examined the impact of ABO compatibility on outcomes of 109 patients who underwent matched unrelated donor (MUD), matched related (REL) and cord blood (CBU) ALLOSCT at our institution since 01/01/2010.

Results:

Median age was 58 years (range, 19.9- 83.6); 33 (30%) were female; 64 (59%) patients had a myeloid, 34 (31%) lymhoid, 8 (7%) plasma cell and 3 (3%) had other disorder; 57 (52%) patients received myeloablative, 25 (23%) nonmyeloablative and 27 (25%) received reduced intensity conditioning. The stem cell sources were represented by 78 (72%) MUDs, 15 (14%) RELs and 16 (15%) CBUs. 80 (86%) of the MUD and REL transplants were 10/10, 11 (13%) were 9/10, 1 (1%) 8/10, and 1 (1%) were 5/10 matched, 13 (80%) of CBU transplants were 6/10 or higher match. 56 (52%) patients were transplanted in CR1/PR1, 39 (36%) had stable disease or <PR and 13 (12%) had resistant or refractory disease. The CMV status was 26 (25%) D-/R-; 40 (39%) D-/R+, 5 (5%) D+/R- and 32 (31%) D+/R+. 61 (56%) patients received ABO compatible transplant, 26 (24%) had a minor incompatibility and 22 (20%) had a major incompatibility.

The major ABO incompatibility group showed a trend towards inferior survival compared to both ABO compatible or minor ABO incompatible transplants. When evaluating conditioning regimens separately similar trend was seen among MA, NMA and RIC transplants, but did not reach statistical significance.

No difference was seen in the following factors: gender, age at SCT, CMV status, acute or chronic GVHD.

Conclusion:

In our experience, the use of a major ABO incompatible donor may represent a risk factor for outcome of ALLOSCT. Analysis of a larger cohort of patients may provide further understanding of the impact of ABO compatibility on ALLOSCT outcome.

Disclosures:
J. Cerny, Incyte Inc., advisory board: Advisory Board and Honoraria
Spectrum Pharmaceutical Inc., advisory board: Advisory Board and Honoraria

R. Nath, Celgene, Advisory Board: Advisory Board and Honoraria
See more of: Poster Session 2: Allogeneic Transplants
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