Pure red cell aplasia following major ABO-incompatible allogeneic hematopoietic stem cell transplantation.
- Author:
Kang-Er ZHU
1
;
Yang XU
;
Dong WU
;
Juan ZHONG
Author Information
1. The First Affiliated Hospital, Medical College of Jinan University, Guangzhou 510630, China. tzhuker@jnu.edu.cn
- Publication Type:Journal Article
- MeSH:
ABO Blood-Group System;
Adolescent;
Adult;
Cyclosporine;
therapeutic use;
Erythrocytes;
pathology;
Erythropoiesis;
Female;
Graft vs Host Disease;
prevention & control;
Hematopoietic Stem Cell Transplantation;
adverse effects;
Humans;
Male;
Middle Aged;
Red-Cell Aplasia, Pure;
etiology;
Transplantation, Homologous;
adverse effects;
Treatment Outcome
- From:
Journal of Experimental Hematology
2002;10(1):61-65
- CountryChina
- Language:English
-
Abstract:
Six out of 20 patients undergoing a major ABO-incompatible allogeneic stem cell transplantation (allo-HSCT) developed pure red cell aplasia (PRCA), which did not show any effects on granulocyte and platelet engraftment, and incidence of grade II-IV aGVHD. All the 6 cases of PRCA were in blood group O recipients of grafts from blood group A donors (n = 5) or blood group B donor (n = 1), suggesting that donor/recipient pair (A/O) is associated with a high risk of PRCA after major ABO-incompatible allo-HSCT. Erythroid engraftment occurred spontaneously in four cases without specific intervention other than the RBC transfusion, which coincided with the decrease of isoagglutinin titers below 8, and the remaining 2 patients with prolonged erythroid aplasia( > 300 days) despite therapy with erythropoietin (EPO) were successfully treated by plasma exchange with donor-type plasma replacement. Cyclosporine did not appear to have played any role in causing PRCA in our patients, however, the occurrence of GVHD may facilitate the recovery of erythropoiesis.
