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目的分析ABO血型不合对白血病患者异基因外周血干细胞移植的影响。方法 38例ABO血型不合及同期30例ABO血型相合的异基因外周血干细胞移植白血病受者进行比较。结果 ABO血型不合组与相合组血红蛋白恢复到100 g/L的时间分别为(73.47±43.04)d和(49.83±38.30)d,差异有统计学意义(P=0.024),移植后3个月内红细胞输注量分别为(10.08±10.10)u和(4.00±3.56)u,差异有统计学意义(P=0.001)。Cox比例风险回归模型示供受者血型(P=0.030)及移植物中单个核细胞计数(P=0.044)与红细胞系恢复时间相关。6例供/受者血型为A/O的患者有2例发生纯红细胞再生障碍性贫血(PRCA),16例供受者主要血型不合患者中有3例发生溶血。ABO血型不合组移植物抗宿主病发生率、巨细胞病毒发生率、死亡率与ABO血型相合组比较差异无统计学意义(P>0.05)。结论ABO血型不合组较相合组红细胞系恢复慢,红细胞输注量多;供受者血型A供O是PRCA高危因素,溶血多见于主要血型不合受者。ABO血型不合不影响造血干细胞的临床结局。
Objective To analyze the effect of ABO incompatibility on allogeneic peripheral blood stem cell transplantation in patients with leukemia. Methods 38 cases of ABO blood group incompatibility and the same period 30 cases of ABO blood group matched allogeneic peripheral blood stem cell transplantation leukemia recipients were compared. Results The time of recovering hemoglobin to 100 g / L in ABO blood group and matched group was (73.47 ± 43.04) d and (49.83 ± 38.30) d, respectively, with statistical significance (P = 0.024). Within 3 months after transplantation The erythrocyte infusions were (10.08 ± 10.10) u and (4.00 ± 3.56) u, respectively, with significant difference (P = 0.001). The Cox proportional hazards regression model showed that donor blood type (P = 0.030) and graft mononuclear cell count (P = 0.044) were correlated with erythrocyte recovery time. Two of six patients with A / O blood donor / recipient had pure erythrocyte aplastic anemia (PRCA), and three of the 16 major donors who received donors had hemolysis. There was no significant difference in the incidence of ABO-GAV group, cytomegalovirus and mortality between ABO group and ABO group (P> 0.05). CONCLUSION: The ABO blood group is slower than that of the matched group, and the amount of erythrocyte is more than that of the matched group. The donors’ blood group A is the high risk factor of PRCA, and the hemolysis is more common in the major blood group. ABO blood group does not affect the clinical outcome of hematopoietic stem cells.