目的:探讨ABO血型不合对并基因造血干细胞移植(allo-HSCT)疗效及并发症的影响.方法:对温州医科大学附属第一医院54例接受allo-HSCT的ABO血型不合受者及同期54例ABO血型相合受者进行了比较,观察两组造血重建的特点.结果:ABO血型不合组与相合组对比中的中性粒细胞和血小板重建时间均无明显统计学差异(P＞0.05),但ABO血型不合allo-HSCT可导致红系恢复延迟,红细胞及血小板输注量增多(P＜0.01);移植物中CD34+细胞数量和年龄是影响红系重建的重要因素.ABO血型不合组受者巨细胞病毒(CMV)感染率、急性移植物抗宿主病(aGVHD)发生率及1年、3年总生存率与ABO血型相合组受者比较差异无统计学意义(P＞0.05).结论:AB0血型不合组allo-HSCT较ABO血型相合组红系恢复慢,红细胞及血小板输注需求量大;ABO血型不合不影响造血干细胞的植活.%Objective:To investigate the effect of ABO-incompatibility on the efficacy and complications of allogeneic hematopoietic stem cell transplantation(HSCT).Methods:The clinical data of 54 recipients who received ABO-incompatible allo-HSCT were retrospectively analyzed and were compared with 54 ABO-identical recipients as controls.Hematopoietic reconstruction and the blood type conversion time were dynamically observed and compared between 2 groups.Results:The time of erythrocyte reconstitution was prolonged to 24 d in ABO-incompatible group,compared with that of 19 d in ABO-compatible group (P ＜ 0.01).The difference of neutrophil and platelet reconstruction was not statistically significant (P ＞ 0.05).Major mismatch group and bidirectional mismatch group required more erythrocyte transfusions than that of ABO-compatible group.The surface antigen of erythrocyte change in major mismatch group was earlier than that of minor mismatch group (P ＜ 0.05).The incidence of cytomegalovirus (CMV) infection,acute graft versus host disease (aGVHD) and survival were not significantly different between 2 groups.Conclusion:ABO-incompatibility can not influence the effect of allo-HSCT,but ABO-incompatibility delayed erythrocyte recovery,and required more RBC and platelet transfusions.
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