Haemolysis after T-cell depleted bone marrow transplantation involving minor AB0 incompatibility.
9 recipients of T-cell depleted allogeneic bone marrows (8 group A, 1 group AB) from group 0 donors were monitored after transplantation. Free anti-A/B was demonstrable in 8 of the 9 recipients 10-19 d post-transplant, 5 patients developed a positive direct anti-globulin test and 7 showed a rise in bilirubin. The presence of antibody was generally unrelated to the infusion of incompatible plasma, although 2 patients who also received anti-CMV immunoglobulin subsequently shown to contain high titre IgG anti-A/B were more severely affected, sustaining a fall in Hb of up to 2 g/d. These observations suggest that, after T-cell depleted bone marrow transplantation, immunocompetent B lymphocytes of donor origin are transferred, secrete antibody in the recipient, and may be responsible for self-limiting haemolytic episodes.
D000017:ABO Blood-Group System / Q000276:immunology*; D000328:Adult; D000744:Anemia, Hemolytic, Autoimmune / Q000175:diagnosis / Q000209:etiology*; D001219:Aspartate Aminotransferases / Q000097:blood; D001323:Autoantibodies / Q000032:analysis; D001402:B-Lymphocytes / Q000276:immunology; D001663:Bilirubin / Q000097:blood; D001782:Blood Donors; D001787:Blood Group Incompatibility / Q000276:immunology*; D016026:Bone Marrow Transplantation; D003298:Coombs Test; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D013601:T-Lymphocytes / Q000276:immunology*
D000017:ABO Blood-Group System; D001323:Autoantibodies; D007074:Immunoglobulin G; D001219:Aspartate Aminotransferases; D001663:Bilirubin