Selected studies evaluating ABO compatibility and transplantation outcomes (2000-2020)
| Reference . | Year . | ABO match, n (%)* . | RIC, n (%) . | Related donor, n (%) . | BM graft, n (%)* . | GVHD prophylaxis . | Engraftment . | GVHD rate . | Relapse rate . | NRM . | OS . |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 16 | 2000 | 083 (53)65 (41)10 (6) | None | All related | —62 (74.7)46 (70.8)7 (70.0) | CNI + MTX | NS | No data | No data | No data | No data |
| 118 | 2001 | 2860 (41)1670 (24)1802 (26)587 (8) | No data | All matched unrelated | All BM | Various regimens | NS | NS | No data | No data | NS |
| 119 | 2005 | 2108 (68)451 (21)430 (14)114 (4) | 258 (12)46 (10)54 (13)17 (15) | All related | All BM | CNI + MTX | Delayed engraftment in major ABO incompatibility | NS | NS | NS | NS |
| 120 | 2007 | 121 (56)40 (19)40 (19)15 (7) | 0.5% of all patients | 86 (71)No data17 (43)No data | No data | CNI ± MTX; MTX alone | NS | NS | NS | NS | NS |
| 121 | 2008 | Major 205 (18.5)Minor 187 (17) | All patients | 932 (84) of all patients | 213 (19) of all patients | CNI only in 430 (39%) | No data | Higher in minor ABO incompatibility | No data | No data | Worse in minor ABO incompatibility |
| 122 | 2008 | 2820 (47)1834 (31)1202 (20)143 (2) | 348 (12)152 (8)136 (11)30 (21) | No data | No data | CNI + MTX | Delayed engraftment in major ABO incompatibility | Higher in major and minor ABO incompatibility | NS | Higher in major and minor ABO incompatibility | Worse in major and minor ABO incompatibility |
| 43 | 2009 | 58 (38)30 (19)44 (29)22 (14) | 17 (29)8 (27)15 (34)16 (73) | All matched unrelated | 27 (47)8 (27)22 (50)9 (41) | CNI + MTX/MMF; 10% with CNI only | No data | Higher acute GVHD rate in minor ABO incompatibility | NS | NS | NS |
| 23 (Stanford) | 2015 | 1053 (61)297 (17)309 (18)78 (4) | 526 (30) of all patients | 1303 (75) of all patients | 727 (42) of all patients | Various | No data | NS | NS | Higher in minor ABO incompatibility | Worse in minor ABO incompatibility, especially in BM grafts |
| CIBMTR(B-cell lymphoma) | 240 (59)73 (18)73 (18)22 (5) | 238 (55) of all patients | 330 (76) of all patients | None | Various | No data | NS | NS | Higher in minor ABO incompatibility | Worse in minor ABO incompatibility | |
| CIBMTR (AML or MDS) | 2608 (50)1084 (21)977 (19)311 (6) | 1448 (28) of all patients | 2079 (40) of all patients | 2333 (45) of all patients | Various | No data | NS | NS | Higher in major ABO incompatibility | Worse in major ABO incompatibility | |
| 42 | 2016 | 252 (49)105 (21)117 (23)38 (7) | 192 (76)78 (74)86 (74)30 (79) | 108 (43)25 (24)32 (27)7 (18) | None | No data | Delayed PLT engraftment in major ABO incompatibility | NS | NS | No data | NS |
| 123 (mismatched unrelated donor, AML) | 2017 | 349 (40)215 (25)241 (28)71 (8) | 193 (55)122 (57)154 (64)38 (54) | None | None | CNI-based in 87% of all patients | NS | Lower grade 2-4 acute GVHD rate in major ABO incompatibility | NS | NS | NS |
| 24 (haploidentical, AML) | 2017 | 522 (63)127 (15)150 (18)38 (5) | 215 (41)45 (35)68 (45)12 (32) | All haploidentical | 279 (53)76 (60)83 (55)19 (55) | No data | Delayed engraftment in major ABO incompatibility | Higher grade 2-4 acute GVHD in bidirectional | NS | NS | Worse in major ABO incompatibility + BM graft |
| 21 | 2017 | 704 (47)324 (22)372 (25)102 (7) | 301 (43)128 (40)151 (41)54 (53) | 372 (53)101 (31)88 (24)23 (23) | 296 (42)87 (27)73 (17)19 (19) | No data | Delayed neutrophil engraftment only in bidirectional with umbilical cord blood graft | NS | NS | NS | NS |
| 41 (severe aplastic anemia) | 2020 | 114 (57)47 (24)38 (19)0 | All patients | All haploidentical | Both BM and PB in all patients | CNI + MMF | NS | Grade 3-4 acute GVHD more common in minor ABO incompatibility | No data | No data | NS |
| 124 | 2020 | 590 (59.0)164 (16.4)191 (19.1)55 (5.5) | 110 (17)32 (20)35 (18)18 (33) | 531 (90)124 (76)145 (76)34 (62) | 189 (32)33 (20)41 (22)8 (15) | CNI + MTX | Neutrophil engraftment delayed in mismatched groups | NS | NS | NS | NS |
| Reference . | Year . | ABO match, n (%)* . | RIC, n (%) . | Related donor, n (%) . | BM graft, n (%)* . | GVHD prophylaxis . | Engraftment . | GVHD rate . | Relapse rate . | NRM . | OS . |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 16 | 2000 | 083 (53)65 (41)10 (6) | None | All related | —62 (74.7)46 (70.8)7 (70.0) | CNI + MTX | NS | No data | No data | No data | No data |
| 118 | 2001 | 2860 (41)1670 (24)1802 (26)587 (8) | No data | All matched unrelated | All BM | Various regimens | NS | NS | No data | No data | NS |
| 119 | 2005 | 2108 (68)451 (21)430 (14)114 (4) | 258 (12)46 (10)54 (13)17 (15) | All related | All BM | CNI + MTX | Delayed engraftment in major ABO incompatibility | NS | NS | NS | NS |
| 120 | 2007 | 121 (56)40 (19)40 (19)15 (7) | 0.5% of all patients | 86 (71)No data17 (43)No data | No data | CNI ± MTX; MTX alone | NS | NS | NS | NS | NS |
| 121 | 2008 | Major 205 (18.5)Minor 187 (17) | All patients | 932 (84) of all patients | 213 (19) of all patients | CNI only in 430 (39%) | No data | Higher in minor ABO incompatibility | No data | No data | Worse in minor ABO incompatibility |
| 122 | 2008 | 2820 (47)1834 (31)1202 (20)143 (2) | 348 (12)152 (8)136 (11)30 (21) | No data | No data | CNI + MTX | Delayed engraftment in major ABO incompatibility | Higher in major and minor ABO incompatibility | NS | Higher in major and minor ABO incompatibility | Worse in major and minor ABO incompatibility |
| 43 | 2009 | 58 (38)30 (19)44 (29)22 (14) | 17 (29)8 (27)15 (34)16 (73) | All matched unrelated | 27 (47)8 (27)22 (50)9 (41) | CNI + MTX/MMF; 10% with CNI only | No data | Higher acute GVHD rate in minor ABO incompatibility | NS | NS | NS |
| 23 (Stanford) | 2015 | 1053 (61)297 (17)309 (18)78 (4) | 526 (30) of all patients | 1303 (75) of all patients | 727 (42) of all patients | Various | No data | NS | NS | Higher in minor ABO incompatibility | Worse in minor ABO incompatibility, especially in BM grafts |
| CIBMTR(B-cell lymphoma) | 240 (59)73 (18)73 (18)22 (5) | 238 (55) of all patients | 330 (76) of all patients | None | Various | No data | NS | NS | Higher in minor ABO incompatibility | Worse in minor ABO incompatibility | |
| CIBMTR (AML or MDS) | 2608 (50)1084 (21)977 (19)311 (6) | 1448 (28) of all patients | 2079 (40) of all patients | 2333 (45) of all patients | Various | No data | NS | NS | Higher in major ABO incompatibility | Worse in major ABO incompatibility | |
| 42 | 2016 | 252 (49)105 (21)117 (23)38 (7) | 192 (76)78 (74)86 (74)30 (79) | 108 (43)25 (24)32 (27)7 (18) | None | No data | Delayed PLT engraftment in major ABO incompatibility | NS | NS | No data | NS |
| 123 (mismatched unrelated donor, AML) | 2017 | 349 (40)215 (25)241 (28)71 (8) | 193 (55)122 (57)154 (64)38 (54) | None | None | CNI-based in 87% of all patients | NS | Lower grade 2-4 acute GVHD rate in major ABO incompatibility | NS | NS | NS |
| 24 (haploidentical, AML) | 2017 | 522 (63)127 (15)150 (18)38 (5) | 215 (41)45 (35)68 (45)12 (32) | All haploidentical | 279 (53)76 (60)83 (55)19 (55) | No data | Delayed engraftment in major ABO incompatibility | Higher grade 2-4 acute GVHD in bidirectional | NS | NS | Worse in major ABO incompatibility + BM graft |
| 21 | 2017 | 704 (47)324 (22)372 (25)102 (7) | 301 (43)128 (40)151 (41)54 (53) | 372 (53)101 (31)88 (24)23 (23) | 296 (42)87 (27)73 (17)19 (19) | No data | Delayed neutrophil engraftment only in bidirectional with umbilical cord blood graft | NS | NS | NS | NS |
| 41 (severe aplastic anemia) | 2020 | 114 (57)47 (24)38 (19)0 | All patients | All haploidentical | Both BM and PB in all patients | CNI + MMF | NS | Grade 3-4 acute GVHD more common in minor ABO incompatibility | No data | No data | NS |
| 124 | 2020 | 590 (59.0)164 (16.4)191 (19.1)55 (5.5) | 110 (17)32 (20)35 (18)18 (33) | 531 (90)124 (76)145 (76)34 (62) | 189 (32)33 (20)41 (22)8 (15) | CNI + MTX | Neutrophil engraftment delayed in mismatched groups | NS | NS | NS | NS |
AML, acute myeloid leukemia; CIBMTR, Center for International Blood and Marrow Transplant Research; CNI, calcineurin inhibitor; MDS, myelodysplastic syndrome; MMF, mycophenolate mofetil; MTX, methotrexate; NRM, nonrelapse mortality; NS, not significant; OS, overall survival; PLT, platelets; RIC, reduced-intensity conditioning.
Data given in the following order: matched, major, minor, bidirectional.