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Acute Myeloid Leukaemia

Does donor–recipient ABO incompatibility protect against relapse after allogeneic bone marrow transplantation in first remission acute myeloid leukemia?

Bone Marrow Transplantation volume 29, pages 853–859 (2002)Cite this article

Abstract

It is not known if donor–recipient ABO blood group incompatibility contributes to graft-versus-leukemia after allogeneic BMT. One hundred and nineteen patients with acute myeloid leukemia in first remission underwent non-T cell-depleted marrow allografts from HLA-identical siblings after TBI and cyclophosphamide (n = 72) or melphalan (n = 47). GVHD prophylaxis comprised cyclosporine alone or cyclosporine-methotrexate. Twenty-two patients relapsed at 3–46 months (median 7): 18 of 76 patients with ABO-matched donors and four of 43 patients with ABO-mismatched donors (actuarial 5-year probabilities 33 ± 6% vs 12 ± 6%; P = 0.028). The incidence of acute and chronic GVHD was not affected by ABO mismatch. The following factors were studied in Cox analysis for effect on outcome: gender, age, FAB subtype, ABO mismatch, CR–transplant interval, conditioning, TBI dose, nucleated cell dose, lymphocyte recovery, acute GVHD, and chronic GVHD. Donor–recipient ABO match was the only factor independently associated with a higher risk of relapse (RR = 3.7; 95% Cl, 1.1–12.6; P = 0.04). ABO mismatch was also associated with superior overall and disease-free survivals. We conclude that ABO incompatibility may influence relapse rates and survival favorably after allogeneic BMT. It is not known if this holds true for allogeneic blood stem cell transplants.

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Acknowledgements

This study was supported by the Bud Flanagan Leukaemia Fund, the David Adams Leukaemia Fund, the Cancer Research Campaign and the Institute of Cancer Research.

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Author notes

  1. S Singhal

    Present address: Division of Hematology/Oncology, Department of Internal Medicine, Hematopoietic Stem Cell Transplant Program, Northwestern University Medical School and The Robert H Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA

Authors and Affiliations

  1. Leukaemia Unit, The Royal Marsden Hospital Institute for Cancer Research, Surrey, UK

    J Mehta, R Powles, B Sirohi, J Treleaven, S Kulkarni, R Saso, D Tait & S Singhal

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Mehta, J., Powles, R., Sirohi, B. et al. Does donor–recipient ABO incompatibility protect against relapse after allogeneic bone marrow transplantation in first remission acute myeloid leukemia?. Bone Marrow Transplant 29, 853–859 (2002). https://doi.org/10.1038/sj.bmt.1703545

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