ABO-incompatible bone-marrow transplantation: removal of red blood cells from donor marrow avoiding recipient antibody depletion.
Eight patients with acute leukaemia undergoing allogeneic bone-marrow transplantation from ABO-incompatible donors received red-cell-depleted donor marrow without any procedure to diminish their anti-ABO antibody titres. Successful marrow red-cell removal (mean 98.8%) was achieved by means of a large-volume separation technique on Ficoll-Metrizoate in the IBM 2991 blood-cell processor. Clinically significant ABO-haemolytic reaction was prevented in all patients, and there was neither failure of engraftment nor rejection. This approach used alone is satisfactory for most ABO-incompatible marrow-transplant recipients, although combining this with some method of recipient antibody depletion, such as plasma exchange, is recommended in the occasional patient with high anti-ABO titres.
D000017:ABO Blood-Group System / Q000235:genetics / Q000276:immunology*; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001787:Blood Group Incompatibility / Q000517:prevention & control*; D001854:Bone Marrow Cells; D016026:Bone Marrow Transplantation; D002469:Cell Separation; D002648:Child; D002675:Child, Preschool; D004912:Erythrocytes; D005260:Female; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology; D006801:Humans; D007938:Leukemia / Q000628:therapy; D008297:Male
D000017:ABO Blood-Group System; D006680:HLA Antigens