Rh antibodies against the pretransplant red cells following Rh-incompatible bone marrow transplantation.
A 22-year-old, blood group O, Rh-positive (R2r) man received bone marrow from his blood group A, Rh-negative (rr), HLA-identical sister for treatment of acute lymphocytic leukemia. The patient's pretransplantation serum contained anti-A in a low concentration; therefore, plasmapheresis was not done prior to transfusion of bone marrow. To prevent graft-versus-host disease, bone marrow was incubated with absorbed rabbit antithymocyte globulin prior to infusion, and the patient was treated with methotrexate in the posttransplantation period. After transplantation, the patient received 6 units of group O, Rh-negative (rr) packed red cells from random donors and 6 units of platelets from the marrow donor. Three months after transplantation, 0.5 percent of his red cells were still of the host's type (group O, Rh-positive), as detected by immunofluorescence technique in blood smears. Four months after transplantation, three different Rh antibodies--anti-D, -E, and -G--were detected. Since the patient received only Rh-negative red cell transfusions, it is concluded that he was immunized to his original red cells.
D000328:Adult; D000917:Antibody Formation; D001323:Autoantibodies / Q000032:analysis; D001788:Blood Grouping and Crossmatching; D001853:Bone Marrow / Q000276:immunology; D016026:Bone Marrow Transplantation; D004912:Erythrocytes / Q000276:immunology*; D005455:Fluorescent Antibody Technique; D006801:Humans; D007945:Leukemia, Lymphoid / Q000628:therapy; D008297:Male; D012204:Rh-Hr Blood-Group System / Q000276:immunology*
D001323:Autoantibodies; D012204:Rh-Hr Blood-Group System