Objective: 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 11 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 ABOidentical, 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.
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。