[The Impact of ABO Minor-Compatible Platelet Transfusion on the Efficacy of Transfusion in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation].

OBJECTIVE

To investigate the impact of long-term and repeated ABO mismatched (minor-compatible) platelet transfusion on the clinical transfusion efficacy in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT), with the aim of providing a scientific and rational basis for clinical platelet transfusion strategies.

METHODS

A retrospective analysis was conducted on 674 hematological patients who received platelet transfusions following allo-HSCT in our hospital from June 2022 to May 2024. Among them, 390 patients (57.86%) received ABO-identical platelet transfusions, while 284 patients (42.14%) received ABO-mismatched platelet transfusions. Clinical efficacy was evaluated based on the change in platelet count 12 hours post-transfusion (△PLT), corrected count increment (CCI), incidence of clinical bleeding complications, anti-A/B antibody titer levels of the patient's plasma and engraftment status.

RESULTS

Although the CCI values in the ABO-mismatched platelet transfusion group were lower than those in the ABO-identical group (P < 0.001), there were no statistically significant differences in platelet transfusion frequency, total transfusion volume, incidence of bleeding complications during hospitalization, and duration of granulocyte recovery post-transplant (P > 0.05). Among the patients who received minor-compatible platelet transfusions, 106 (37.32%) patients who received mixed blood-type platelet transfusions showed significant differences in platelet transfusion frequency, total transfusion volume, and duration of granulocyte recovery post-transplant compared to 178 (62.68%) patients who received single blood-type platelet transfusions (all P < 0.05). A subgroup analysis based on the anti-A/B antibody titers in the plasma of ABO-incompatible allo-HSCT patients revealed that, regardless of whether the anti-A/B antibodies were of the IgG or IgM class, there were no significant differences in the total volume of platelet transfusions post-transplant across the different antibody titer groups (P >0.05).

CONCLUSION

ABO-identical platelet transfusion significantly improves platelet recovery and survival in allo-HSCT patients. During long-term multiple transfusions, minor-compatible platelets exhibit comparable efficacy to ABO-identical platelets, however, when two compatible blood types are available, single-type platelet transfusion demonstrates superior efficacy.