Delayed platelet engraftment in group O patients after autologous progenitor cell transplantation

BACKGROUND: Fucosylated glycans, including H-antigen, play critical roles in hematopoietic progenitor cell homing, adhesion, growth, and differentiation. H-active antigens are strongly expressed on CD34+ progenitor cells and committed megakaryocytic progenitors and may mediate adhesion to marrow stromal fibroblasts. We examined the possible influence of donor ABO type on platelet (PLT) engraftment after autologous peripheral blood progenitor cell transplant (PBPCT). STUDY DESIGN AND METHODS: A retrospective analysis of all patients who underwent a single autologous PBPCT between 1996 and 2000 were reviewed. Neutrophil and PLT engraftment were compared by patient ABO type and CD34+ cell dose by t test, chi-square test, analysis of variance, Kaplan-Meier probability, and log-rank test. RESULTS: Engraftment data was available in 195 patients. PLT engraftment was delayed in all patients, regardless of ABO type, at CD34+ PBPC doses of 2 × 10⁶ to 3 × 10⁶ per kg (p < 0.001). When examined by ABO type, late PLT engraftment (PLT count >50 × 10⁹/L) was significantly delayed in group O patients relative to all non-group O patients (32.4 days vs. 19.6 days, p < 0.001). Approximately 50 percent of group O patients required more than 40 days to achieve late PLT recovery (p < 0.005). CONCLUSIONS: A group O phenotype may be associated with delayed PLT engraftment at lower CD34 doses.