Abstract：
BACKGROUND: ABO incompatibility is not a contraindication but would affect the prognosis of allogeneic hematopoietic stem cell transplantation (allo-HSCT). The dynamic change of blood phenotype is not only related to the patient\'s status, but also the basis for the implementation of compatible blood transfusion. The criteria for judging a complete transformation to donor-type and the principle of blood transfusion at relapse need to be unified. We aimed to illustrate the significance of blood group monitoring after allo-HSCT.
METHODS: We collected 263 patients underwent ABO incompatible allo-HSCT from January 2010 to December 2019, and monitored blood type regularly according to the frequency of the patient\'s return visits till complete conversion or death. Non-parametric test was used to find differences among incompatible groups. We analyzed factors potentially influence blood type conversion by Binary Logistic model. Cox regression model was used to illustrate the relationship between blood-type conversion and prognosis.
RESULTS: The median days of conversion were 107, 91 and 108 in major-, minor- and bidirectional groups respectively. Blood type conversion correlated with HLA compatibility (P = 0.012, OR=2.69) and acute graft-versus-host-disease (P = 0.001, OR=0.06). Patients with incomplete blood type conversion had a higher death rate than those with complete blood type conversion(P = 0.003, OR=3.703).
CONCLUSIONS: Blood type monitoring can help to evaluate the prognosis of transplantation and assess the risk of death. It is recommended to monitor the changes of blood group antigens and antibodies, especially within a year after transplantation, to predict the risk of adverse events (such as GVHD, recurrence, death, etc.).
METHODS: We collected 263 patients underwent ABO incompatible allo-HSCT from January 2010 to December 2019, and monitored blood type regularly according to the frequency of the patient\'s return visits till complete conversion or death. Non-parametric test was used to find differences among incompatible groups. We analyzed factors potentially influence blood type conversion by Binary Logistic model. Cox regression model was used to illustrate the relationship between blood-type conversion and prognosis.
RESULTS: The median days of conversion were 107, 91 and 108 in major-, minor- and bidirectional groups respectively. Blood type conversion correlated with HLA compatibility (P = 0.012, OR=2.69) and acute graft-versus-host-disease (P = 0.001, OR=0.06). Patients with incomplete blood type conversion had a higher death rate than those with complete blood type conversion(P = 0.003, OR=3.703).
CONCLUSIONS: Blood type monitoring can help to evaluate the prognosis of transplantation and assess the risk of death. It is recommended to monitor the changes of blood group antigens and antibodies, especially within a year after transplantation, to predict the risk of adverse events (such as GVHD, recurrence, death, etc.).
摘要：
背景：ABO不相容性不是禁忌症，但会影响异基因造血干细胞移植（allo-HSCT）的预后。血液表型的动态变化不仅与患者的状态有关,也是实施相容输血的依据。判断完全转变为供体类型的标准和复发时输血的原则需要统一。我们旨在说明allo-HSCT后血型监测的意义。
方法：我们收集了2010年1月至2019年12月接受ABO不相容allo-HSCT的263例患者，并根据患者复诊频率定期监测血型，直至完全转换或死亡。非参数检验用于发现不相容组之间的差异。我们通过二元Logistic模型分析了可能影响血型转换的因素。Cox回归模型用于说明血型转换与预后之间的关系。
结果：转换的中位数分别为107、91和108天，分别为微型和双向组。血型转换与HLA相容性（P=0.012，OR=2.69）和急性移植物抗宿主病（P=0.001，OR=0.06）相关。血型转换不全患者的逝世亡率高于血型转换完全者(P=0.003,OR=3.703)。
结论：血型监测有助于评估移植预后和评估死亡风险。建议监测血型抗原和抗体的变化,尤其是移植后一年内，预测不良事件的风险(如GVHD，复发,死亡,等。).
方法：我们收集了2010年1月至2019年12月接受ABO不相容allo-HSCT的263例患者，并根据患者复诊频率定期监测血型，直至完全转换或死亡。非参数检验用于发现不相容组之间的差异。我们通过二元Logistic模型分析了可能影响血型转换的因素。Cox回归模型用于说明血型转换与预后之间的关系。
结果：转换的中位数分别为107、91和108天，分别为微型和双向组。血型转换与HLA相容性（P=0.012，OR=2.69）和急性移植物抗宿主病（P=0.001，OR=0.06）相关。血型转换不全患者的逝世亡率高于血型转换完全者(P=0.003,OR=3.703)。
结论：血型监测有助于评估移植预后和评估死亡风险。建议监测血型抗原和抗体的变化,尤其是移植后一年内，预测不良事件的风险(如GVHD，复发,死亡,等。).
