Analysis of ABO chimera from peripheral red cells and reticulocytes by flow cytometry and micro gel column technique in patients post-ABO-incompatible HSCT.

BACKGROUND: How to choose an appropriate method to monitoring dynamic ABO chimera post-ABO-incompatible HSCT is crucial to not only assess the status of erythroid engraftment but also achieve personalized safety transfusion.

METHODS: We evaluated the efficacy of micro gel column technique (MGCT) and flow cytometry (FCM) by series of artificial ABO chimera mixtures from 0.5% to 50% and by investigating 15 cases of ABO-incompatible HSCT patients with longitudinally ABO blood grouping and ABO chimera from RBCs and reticulocytes.

RESULTS: 5% and 2% of ABO chimera mixtures can be efficiently detected by MGCT and FCM, respectively. 6.3% of donor RBCs with 44.77% of donor reticulocytes in the early phase and 7.9% of patient RBCs with 96% of donor reticulocytes in the phase of complete donor type can be detected by FCM rather than failure by MGCT simultaneously. However, in case 8#, 8.6% of donor reticulocytes rather than 99.1% of donor RBCs on the 98th day post-HSCT could adequately predict early relapse.

CONCLUSIONS: Investigation of ABO chimera from reticulocytes by FCM is a more effective strategy rather than ABO blood grouping and RBCs by FCM to indicate the true progress of erythroid alteration and achieve personalized safety transfusion post-ABO-incompatible HSCT.