COMPLICATIONS IN ABO-INCOMPATIBLE HEMATOPOIETIC STEM CELL TRANSPLANT IN PAKISTAN

Mussawair Hussain, Imran Ullah, Nighat Shahbaz, Qamar Un Nisa Chaudhry, Mehreen Ali Khan, Tariq Azam Khattak

Abstract


Background: Hematopoietic stem cell transplantation (HSCT) is therapeutic option for many blood diseases. It has increased risk of complications with incompatible pair. The objective of this study was to determine the frequency of complications in ABO-incompatible HSCT in Pakistan.

Materials & Methods: This cross-sectional study was conducted at Armed Forces Bone Marrow Transplant Centre , Rawalpindi, Pakistan from 11th August 2018 till 15th March 2021. A sample of 73 ABO-incompatible HSCT patients was selected. Variables were sex, age groups, acute & delayed hemolysis, pure red cell aplasia and acute GvHD. All variables being categorical were described by count and percentage with 80%CI. Complications in sample vs. population were compared through chi-square goodness of fit test.

RESULTS: Seventy three patients with ABO-incompatible HSCT included 52 (71.23%) men & 21 (28.77%) women, and 49 (67.12%) in age group ≤14 years & 24 (32.88%) in ≥15 years. Out of 73 patients, eight (10.96%) had acute hemolysis, 26 (35.62%) had delayed hemolysis, four (5.84%) had pure red cell aplasia and 34 (46.58%) had acute GvHD. The observed prevalence in sample was similar to population for acute (p=.46893) and delayed hemolysis (p=.30759) and acute GvHD (p=.55841), while it was different for pure red cell aplasia (p=.00006).

CONCLUSION: Most common complication in our study was acute GvHD, followed by delayed hemolysis, acute hemolysis & pure red cell aplasia. The observed prevalence in sample was similar to population for acute & delayed hemolysis and acute GvHD, while it was different for pure red cell aplasia.


Keywords


Complications; Blood Group Incompatibility; Hematopoietic Stem Cell Transplantation; Population; Sex; Age Groups; Hemolysis; Pure Red Cell Aplasia; Graft Versus Host Disease; Pakistan.

Full Text:

PDF

References


Duarte RF, Labopin M, Bader P, Basak GW, Bonini C, Chabannon C et, al. Indications for hematopoietic stem cell transplantation for hematological diseases, solid tumors and immune disorders: current practice in Europe, 2019. Bone marrow transplant 2019 Oct; 54(10):1525-52. https://doi.org/10.1038/s41409-019-0516-2

Gooley TA, Chien JW, Pergam SA, Hingorani S, Sorror ML, Boeckh M, etal. Reduced mortality after allogeniec hematopoietic-cell transplantation. N Engl J Med 2010 Nov 25; 363(22):2091-101. https://doi.org/10.1056/NEJMoa1004383

Worel N. ABO-Mismatched Allogeniec Hematopoietic Stem Cell Transplantation. Transfus Med Hemother 2016 Jan; 43(1):3-12. Epub 2015 Oct 29. PMID: 27022317; PMCID: PMC4797460. https://doi.org/10.1159/000441507

Seebach JD, Stussi G, Passweg JR, Loberiza Jr FR, Gajewski JL, Keating A et, al. ABO blood group barrier in allogeniec bone marrow transplantation revisited. Biol. Blood Marrow Transplant.. 2005 Dec 1; 11(12):1006-13. https://doi.org/10.1016/j.bbmt.2005.07.015

Watz E, Remberger M, Ringden O, Lundahl J, Ljungman P, Mattsson J et, al. Analysis of donor and recipient ABO incompatibility and antibody-associated complications after allogeniec stem cell transplantation with reduced-intensity conditioning. Biol. Blood Marrow Transplant. 2014 Feb 1; 20(2):264-7. https://doi.org/10.1016/j.bbmt.2013.11.011

Zhu KE, Li JP, Zhang T, Zhong J, Chen J. Clinical features and risk factors of pure red cell aplasia following major ABO-Incompatible allogeniec hematopoietic stem cell transplantation. Hematology 2007 Apr; 12(2):117-21. PMID: 17454192. https://doi.org/10.1080/10245330601111540

Vaezi M, Oulad Dameshghi D, Souri M, Setarehdan SA, Alimoghaddam K, Ghavamzadeh A. ABO Incompatibility and Hematopoietic Stem Cell Transplantation Outcomes. Int J Hematol Oncol Stem Cell Res 2017 Apr 1; 11(2):139-147. PMID: 28875009; PMCID: PMC5575727.

Aung FM, Lichtiger B, Bassett R, Liu P, Alousi A, Bashier Q, et al. Incidence and natural history of pure red cell aplasia in major ABO-mismatched hematopoietic cell transplantation. Br J Haematol. 2013 Mar; 160(6):798-805. Epub 2013 Jan 18. PMID: 23330820; PMCID: PMC4078723. https://doi.org/10.1111/bjh.12210

Tomac G, Bojanić I, Mazić S, Vidović I, Raos M, Ćepulić BG, et al. Haemolysis, pure red cell aplasia and red cell antibody formation associated with major and bidirectional ABO-incompatible hematopoietic stem cell transplantation. Blood Transfus 2018 Jul; 16(4):397-404. Epub 2017 Apr 19. PMID: 28488966; PMCID: PMC6034778. https://doi.org/10.2450/2017.0322-16

Rowley SD. Hematopoietic stem cell transplantation between red cell Incompatible donor-recipient pairs. Bone Marrow Transplantation 2001; 28: 315-321. https://doi.org/10.1038/sj.bmt.1703135

Booth GS, Gehrie EA, Bolan CD, Savani BN. Clinical guide to ABO-Incompatible allogeneic stem cell transplantation. Biol Blood Marrow Transplant 2013; 19: 1152-58. https://doi.org/10.1016/j.bbmt.2013.03.018

Glucksberg H, Storb R, Fefer A, Buckner CD, Neiman PE, CliftRA, et al. Clinical manifestations of graft-versus-host diseasein human recipients of marrow from HLA matched siblingdonors. Transplantation 1974; 18(4):295-304. https://doi.org/10.1097/00007890-197410000-00001

Raosoft® sample size calculator [internet]. Seattle, WA, USA: Raosoft Inc.; 2004. [Accessed 2021 April 30]. Available at: http://www.raosoft.com/samplesize.html

Statistics Kingdom. Proportion confidence interval calculator [internet]. Statistics Kingdom; Melbourne, Australia 2007. [Accessed 2021 April 30]. Available at: http://www.statskingdom.com/41_proportion_confidence_interval.html

Zar JH. Biostatistical Analysis. 5th ed. New York: Prentice-Hall, Inc.

Daniel WW. Biostatistics: A Foundation for Analysis in the Health Sciences. 7th ed. Singapore: John Wily; 2005

Social Science Statistics. Statistical Tests Calculators [Internet]. [Accessed 2021 May 02]. Available at: https://www.socscistatistics.com/tests/goodnessoffit/default2.aspx

Ghori MR, Khan H, Marwat M. Distribution of non-malignant hematological disorders by sex, age groups and type of disease based on bone marrow aspiration in population of Khyber Pakhtunkhwa, Pakistan. Gomal J Med Sci 2019 Apr-Jun; 17 (2): 29-36. https://doi.org/10.46903/gjms/17.02.1926

Ain N, Khan S, Marwat M, Khan N, Ahmad I, Ramzan F, et al. Frequency, distribution and determinants of hypertension in adult stroke population of D.I.Khan Division, Pakistan. Gomal J Med Sci 2019 Jul-Sep; 17 (3):81-9. https://doi.org/10.46903/gjms/17.03.2076

Marwat M, Ahmad I, Ashiq F, AliS, ZamirS, Rehman MU, et al. Frequency, distribution and determinants of diabetes mellitus in adult acute coronary syndrome population of D.I.Khan Division, Pakistan. Gomal J Med Sci 2019 Oct-Dec;17 (4):131-43. https://doi.org/10.46903/gjms/17.04.2106

Naqvi SWA, Saeed S, Rafique A, Saeed MH, Khan N, Khan A, et al. Prevalence and distribution of malaria by sex, age groups and species in year 2019 in suspected malarial population of district D.I.Khan, Pakistan. Gomal J Med Sci 2020 Oct-Dec; 18(4):164-73.

Rashid M, Rehman Y, Usman M, Younas M, Bilal M, Jamil M, et al. Distribution of cutaneous leishmaniasis by sex, age groups and residence in year 2020 in cutaneous leishmaniasis population of District D.I.Khan, Pakistan. Gomal J Med Sci 2021 Jan-Mar; 19(1):28-34.




DOI: https://doi.org/10.46903/gjms/19.03.974

Refbacks

  • There are currently no refbacks.


Copyright (c) 2021. Mussawair Hussain, Imran Ullah, Nighat Shahbaz, Qamar Un Nisa Chaudhry, Mehreen Ali Khan, Tariq Azam Khattak.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Gomal Medical College, Daraban Road, Dera Ismail Khan, Pakistan

ISSN: 1819-7973, e-ISSN: 1997-2067

Website: https://www.gmcdikhan.edu.pk

Phone: +92-966-747373

Scimago Journal & Country Rank