摘要目的 研究供受者ABO血型不合对单份非血缘脐血造血干细胞移植(UCBT)患者中性粒细胞、血小板、红细胞植入,急性移植物抗宿主病(aGVHD)累积发生率及180 d移植相关死亡率(TRM)的影响.方法 以2008年4月至2014年10月行单份UCBT的208例患者为研究对象,其中供受者ABO血型相合99例,次要不合60例,主要不合38例,主次均不合11例.全部患者均采用强化清髓预处理方案,并予环孢素联合霉酚酸酯方案预防GVHD.结果 ABO血型相合与不合的UCBT相比,中性粒细胞、血小板、红细胞累积植入率,Ⅱ～Ⅳ度aGVHD、Ⅲ～Ⅳ度aGVHD及180 d TRM的累积发生率差异均无统计学意义(P值均＞ 0.05),且无一例发生纯红细胞再生障碍.A供O血型不合患者中性粒细胞、血小板、红细胞的中位植入时间分别为+17(+12～+28)、+37(+17～+57)、+25(+13～+52)d,Ⅱ～Ⅳ度aGVHD、Ⅲ～Ⅳ度aGVHD及180 d TRM累积发生率分别为37.50％(95％CI 34.39％～40.61％)、6.25％(95％CI 5.48％～7.02％)及23.53％(95％CI 21.30％～25.76％).与ABO血型相合、次要不合及主次均不合组比较,差异均无统计学意义(P值均＞ 0.05).结论 接受ABO血型不合UCBT的患者移植后无纯红细胞再生障碍发生.供受者ABO血型不合对UCBT患者的造血重建、aGVHD发生率及TRM均无影响.

abstractsObjective To retrospectively study the impacts of ABO incompatibility on early outcome after single unit unrelated cord blood transplantation (UCBT), such as cumulative incidence of engraftment, incidence of acute graft-versus-host disease (aGVHD) and 180-day transplant-related mortality (TRM).Methods 208 patients underwent single unit UCBT from April 2008 to October 2014 were analyzed, included 99 ABO-identical, 60 minor, 38 major and 1i bidirectional ABO-incompatible recipients.All the patients received intensified myeloablative conditioning, and a combination of cyclosporine A and mycophenolate mofetil was given for GVHD prophylaxis.Results Cumulative incidences of neutrophil engraftment, platelet recovery, erythroid lineage reconstitution, Ⅱ-Ⅳ aGVHD,Ⅲ-Ⅳ aGVHD and 180-day TRM showed no significant difference among the patients receiving ABO-identical, minor, major, and bidirectional UCBT (all P＞0.05, respectively).What' s more, none of the patients developed pure red-cell aplasia (PRCA) after UCBT.Group A donor and a group O recipient patients didn't appeared to influence the clinical results when compared with others (all P＞0.05,respectively).Conclusion Patients receive ABO-incompatible UCBT may not develop PRCA.The presence of ABO-incompatibility did not influence the hematopoietic reconstitution, the incidence of aGVHD and 180-day TRM in this cohort.There is not support for the need to regard ABO-compatibility as an UCB-graft selection criterion.