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Because bone marrow (BM), the preferred graft from paediatric sibling donors and for non\u2010malignant diseases, has a red blood cell (RBC) content similar to blood, anti\u2010donor isoagglutinins must either be depleted from the recipient or RBCs removed from the graft. To achieve tolerability of unmanipulated BM grafts, we used controlled infusions of donor ABO\u2010type RBC units to deplete isoagglutinins before the transplant. This retrospective study evaluates the outcomes of 52 ABO major incompatible BM transplants performed at our centre between 2007 and 2019. The use of donor\u2010type RBC transfusions was well tolerated. They effectively reduced isoagglutinins levels, typically achieving target titres after one (60%) or two (29%) transfusions. The approach allowed for successful and uneventful infusions of unmanipulated BM which provided timely engraftment. The transplant outcomes were not inferior to those of a matched\u2010pair control group of patients with ABO\u2010identical donors.<\/jats:p>","DOI":"10.1111\/bjh.18761","type":"journal-article","created":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T05:09:15Z","timestamp":1679548155000},"page":"1159-1168","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Donor\u2010type red blood cell transfusion to deplete isoagglutinins prior to allogeneic stem cell transplantation from <scp>ABO<\/scp> major incompatible bone marrow donors"],"prefix":"10.1111","volume":"201","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1639-2697","authenticated-orcid":false,"given":"Andrea","family":"Jarisch","sequence":"first","affiliation":[{"name":"Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, Department for Children and Adolescents Goethe University Frankfurt, University Hospital  Frankfurt\/Main 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