• 中国科学论文统计源期刊
  • 中国科技核心期刊
  • 美国化学文摘(CA)来源期刊
  • 日本科学技术振兴机构数据库(JST)
临床输血与检验

临床输血与检验 ›› 2025, Vol. 27 ›› Issue (4): 518-525.DOI: 10.3969/j.issn.1671-2587.2025.04.012

• 临床研究 • 上一篇    下一篇

ABO血型主要及双向不合对757例非血缘脐血移植结局的影响分析*

张咏1, 耿良权2, 强萍2, 范倩2, 刘会兰1,2   

  1. 1安徽医科大学附属省立医院血液科;
    2中国科学技术大学附属第一医院（安徽省立医院）血液科,安徽合肥 230000
  • 收稿日期:2025-04-20 发布日期:2025-08-22
  • 通讯作者: 刘会兰,主要从事造血干细胞移植研究,（E-mail）huilanl@ustc.edu.cn。
  • 作者简介:张咏,主要从事血液病研究,（E-mail）zhangyong1890@outlook.com。
  • 基金资助:
    *本课题受安徽省重点研究与开发计划（No. 202104j07020045）资助

Impact of Major and Bidirectional ABO Incompatibility on Outcomes of Unrelated Cord Blood Transplantation: An Analysis of 757 Cases

ZHANG Yong1, GENG Liangquan2, QIANG Ping2, FAN Qian2, LIU Huilan1,2   

  1. 1Department of Haematology, Anhui Provincial Hospital Affiliated to Anhui Medical University;
    2Department of Haematology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, 230000
  • Received:2025-04-20 Published:2025-08-22

RichHTML

1

PDF

1

摘要： 目的 探讨ABO血型主要及双向不合对非血缘脐血移植（cord blood transplantation, CBT）结果的影响。方法 收集中国科学技术大学附属第一医院2020年1月—2024年10月收治的757例非血缘CBT的患者临床资料,按供受者ABO血型是否相合分为ABO主要/双向不合组（312例）、相合/次要不合组（445例）,比较主要/双向不合组和相合/次要不合组移植结果。结果 ABO主要/双向不合组与ABO相合/次要不合组中性粒细胞、血小板、红细胞中位植入时间分别为16 d vs. 15 d（P=0.790）、37 d vs. 36 d （P=0.101）、25 d vs. 21 d（P<0.05）,两组均无纯红细胞再生障碍性贫血（pure red cell aplasia, PRCA）发生;与ABO相合/次要不合组相比,Ⅱ-Ⅳ、Ⅲ-Ⅳ度急性移植物抗宿主病（acute graft-versus-host disease, aGVHD）100 d累积发生率和中重度慢性GVHD（Chronic GVHD, cGVHD）2年累积发生率分别为30.5% vs. 28.9%（P=0.996）、20.3% vs. 14.7%（P=0.275）及3.39% vs. 4.14%（P=0.831）;两组1年临床显著巨细胞病毒（cytomegalovirus, CMV）感染率分别为73.5% vs. 69.3%（P=0.316）,两组2年移植相关死亡率（transplant-related mortality, TRM）、2年总生存率（overall survival, OS）分别为15.3% vs. 13.2%（P=0.791）、76.9% vs. 78.3%（P=0.743）。结论 ABO血型主要及双向不合对CBT患者移植后植入、aGVHD、cGVHD、CMV感染的发生、TRM及OS等无显著影响,尽管ABO血型主要/双向不合组红细胞植入明显延缓,但是未观察到移植相关PRCA的发生。

关键词: ABO血型主要不合, 非血缘脐血移植, 纯红细胞再生障碍性贫血, 移植物抗宿主病, 巨细胞病毒感染, 移植相关死亡率, 总生存率

Abstract: Objective To investigate the impact of major and bidirectional ABO blood group incompatibility on the outcomes of unrelated cord blood transplantation (CBT). Methods This retrospective study included 757 patients who underwent unrelated CBT at the First Affiliated Hospital of the University of Science and Technology of China from January 2020 to October 2024. Based on donor-recipient ABO compatibility, patients were categorized into two groups: the major/bidirectional incompatibility group (n=312) and the compatible/minor incompatibility group (n=445). Transplantation outcomes were compared between the two groups. Results The median time to neutrophil, platelet, and red blood cell engraftment was 16 vs. 15 days (P=0.790), 37 vs. 36 days (P=0.101), and 25 vs. 21 days (P<0.05), respectively, in the major/bidirectional incompatibility group compared with the compatible/minor incompatibility group. No cases of pure red cell aplasia (PRCA) were observed in either group. The 100-day cumulative incidence of grade Ⅱ-Ⅳ and grade Ⅲ-Ⅳ acute graft-versus-host disease (aGVHD) was 30.5% vs. 28.9% (P=0.996) and 20.3% vs. 14.7% (P=0.275), respectively; the 2-year cumulative incidence of moderate-to-severe chronic GVHD (cGVHD) was 3.39% vs. 4.14% (P=0.831). The 1-year incidence of clinically significant cytomegalovirus (CMV) infection was 73.5% vs. 69.3% (P=0.316). The 2-year transplant-related mortality (TRM) and overall survival (OS) rates were 15.3% vs. 13.2% (P=0.791) and 76.9% vs. 78.3% (P=0.743), respectively. Conclusion Major and bidirectional ABO incompatibility had no significant effect on engraftment, incidence of aGVHD and cGVHD, CMV infection, TRM, or OS in CBT patients. Although red blood cell engraftment was significantly delayed in the major/bidirectional incompatibility group, no transplantation-related PRCA was observed.

Key words: Major ABO incompatibility, Unrelated cord blood transplantation, Pure red cell aplasia, Graft-versus-host disease, Cytomegalovirus infection, Transplant-related mortality, Overall survival

中图分类号: