PDF(Pubmed)
Abstract：
ABO-group major incompatibility hematopoietic stem cell transplantation (HSCT) increases the risk of delayed red cell engraftment and other immunological complications. In this study, we evaluated the efficacy of pre-transplant infusion of rituximab in patients with ABO-incompatibility in improving red blood cell engraftment after HSCT, measured by time to reach transfusion independence. We performed a retrospective, single-center study including 131 consecutive patients transplanted with major or bidirectional ABO-incompatible grafts between 1st January 2013 and 31st December 2019. Fifty-one patients received an infusion of rituximab during the conditioning regimen, while 80 patients did not receive any additional preventive treatment. Time to transfusion independence was significantly reduced for patients treated with rituximab (1 month, 95% CI, 0.5-2) compared with the control group (3.2 months, 95% CI 1.5-3.2, p = 0.02). By multivariable analysis, rituximab use was associated with a faster red blood cell (RBC) engraftment (RR 1.88, 95% CI 1.17-3.03, p = 0.009), while a pre-transplant anti-donor isohemagglutinins titer >1:128 was associated with delayed transfusion independence (RR 0.61, 95% CI 0.37-0.99, p = 0.05). Although limited by the retrospective nature of the study, the results of this analysis suggest that rituximab added to conditioning regimens is feasible, safe, and able to improve post-transplant red blood cell engraftment.
摘要：
ABO组主要不相容性造血干细胞移植（HSCT）会增加红细胞移植延迟和其他免疫并发症的风险。在这项研究中,我们评估了移植前输注利妥昔单抗对ABO不相容患者HSCT后红细胞移植的疗效，以达到输血独立的时间来衡量。我们做了一个回顾,单中心研究纳入了2013年1月1日至2019年12月31日期间131例接受大型或双向ABO不相容移植物移植的连续患者.51名患者在调理方案期间接受了利妥昔单抗的输注，而80例患者没有接受任何额外的预防性治疗。使用利妥昔单抗治疗的患者的输血独立时间显着减少（1个月，95%CI,0.5-2)与对照组(3.2个月,95%CI1.5-3.2，p=0.02）。通过多变量分析，利妥昔单抗的使用与更快的红细胞（RBC）植入相关（RR1.88，95％CI1.17-3.03，p=0.009），而移植前抗供体同血凝素滴度>1:128与延迟输血独立性相关(RR0.61,95%CI0.37-0.99,p=0.05)。尽管受限于研究的回顾性性质，这项分析的结果表明，利妥昔单抗加入调理方案是可行的，安全,并能够改善移植后红细胞的植入。
