АВ0-НЕСОВМЕСТИМОСТЬ ПРИ АЛЛОГЕННОЙ ТРАНСПЛАНТАЦИИ ГЕМОПОЭТИЧЕСКИХ КЛЕТОК: АНАЛИЗ 15-ЛЕТНЕГО ОПЫТА НИИ ДЕТСКОЙ ОНКОЛОГИИ, ГЕМАТОЛОГИИ И ТРАНСПЛАНТОЛОГИИ ИМЕНИ Р. М. ГОРБАЧЕВОЙ
2017
Introduction. AB0-incompatibility in different types of allogeneic hematopoietic stem cell transplantation (HSCT) may be an additional aggravating factor for the development of immunological complications and decrease treatment efficacy. Materials and methods. From May 1999 to December 2015 in R.M. Gorbacheva Memorial Research Institute for Children Oncology, Hematology and Transplantation 1131 patients with malignancies and hereditary diseases were included to the study, which were performed 1428 allogeneic HSCT: allogeneic unrelated – 814 (57.0 %), allogeneic related – 344 (24.1 %), haploidentical – 267 (18.7 %), umbilical cord blood in 3 patients (0.2 %). Age was 0–76 years, median – 25 years. Results. In 54.6 % of cases (n = 780) АВ0-incompatibility was determined: major – 37.8 % (n = 295); minor – 45.4 % (n = 354); combined – 16.8 % (n = 131). АВ0-incompatibility in allogeneic HSCT did not influence overall survival (p = 0.56), frequency of acute graftversus-host disease (GVHD) (p = 0.2). There was an increased frequency of acute GVHD in combination with reduced intensity conditioning regimens and АВ0-incompatibility (30.8 %) compared with myeloablative regimens (15.3 %; p = 0.002). Conclusion. The presence of АВ0-incompatibility is not a limiting factor to perform allogeneic HSCT, however, it demands high quality prophylaxis and sophisticated transfusion therapy to prevent immune complications.
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