2016 Volume 62 Issue 6 Pages 699-704
Allogeneic hematopoietic stem cell transplantation (SCT) can be performed across the ABO barrier if measures are taken to prevent acute hemolysis. In minor and bidirectional ABO-incompatible SCT, the lack of graft-versus-host (GvH) isoagglutinin is often experienced in routine blood tests; however, changes in donors' isoagglutinins against recipients' A or B antigen are not fully understood. We reviewed the routine ABO blood typing test of 61 recipients of hematopoietic stem cells from minor or bidirectional ABO-incompatible donors. Isoagglutinins were persistently negative in 52 recipients, transiently positive in 6, and positive after the transition of red cell type to donors' in 3. In the 3 recipients, one was the third SCT (patient was originally O, the 2nd donor AB, the last donor A), and the others were the second SCT and returned to each patient's original blood type. GvH isoagglutinins were detected if the last donor's isoagglutinin was the same or a part of the recipient's original pattern in this study. Although the mechanism has not been elucidated, absorption of GvH isoagglutinins to various sites of the body is considered to play an important role in the lack of detection of GvH agglutinin in minor or bidirectional ABO-incompatible SCT.
