Demonstration of genetic blood group transition in patients undergoing ABO-mismatched hematopoietic stem cell transplantation by peripheral blood quantitative polymerase chain reaction targeting the ABO locus

Patients undergoing hematopoietic stem cell transplantation (HSCT), a potentially curative therapy often used to treat cancers of the blood and bone marrow, often require blood transfusion while donor stem cells engraft and begin to produce functional blood cells. Transplants with ABO blood group mismatches between donor and recipient (e.g. type A donor to type B patient) can be complicated from a transfusion perspective because identifying the precise time of blood type switching (from recipient to donor) using
current methods is imperfect, and while awaiting definitive evidence of blood type switching patients often receive universal donor products (often low in stock and saved for emergencies). Genetic testing for blood group identification is expanding in transfusion medicine, however studies have not evaluated its use in determining the timing of blood type switching in HSCT recipients. We propose testing ABO-mismatched HSCT recipients serially using routine methods (serology) and genetic testing to attempt to identify with greater precision the time of blood type switching in these patients. We hope to demonstrate the utility of genetic testing in reducing unnecessary excess use of valuable universal donor blood products and reducing exposures of patients to ABO out-of-group blood products, potentially associated with worse outcomes.

SHIH, Andrew

University of British Columbia

Blood Efficiency Accelerator Program

Ontario

15990.0