title: Erythropoietin in the treatment of delayed immune hemolysis of a major ABO-incompatible bone marrow transplant.
abstract: Delayed immune hemolysis can be observed after major ABO-incompatible bone marrow transplants (BMT). The management of these hemolytic episodes includes transfusion of group O red blood cells and increases of immunosuppression. Here we report the case of a 25-year-old patient who developed overt immune hemolysis on day +50 after a HLA-identical ABO-incompatible BMT. To avoid added immunosuppression, erythropoietin was started: an increase in reticulocytes sufficient to maintain hemoglobin despite persistent hemolysis was observed. We conclude that erythropoietin may have a role in the management of delayed-onset hemolysis of major ABO-incompatible BMT, especially when added immunosuppression is undesirable.
authors.affiliation: Hermatology Department, Hospital de La Princesa, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: López
authors.forename: J L
authors.initials: JL
authors.lastname: Steegmann
authors.forename: G
authors.initials: G
authors.lastname: Pérez
authors.forename: M J
authors.initials: MJ
authors.lastname: Otero
authors.forename: M
authors.initials: M
authors.lastname: Berberana
authors.forename: R
authors.initials: R
authors.lastname: Cámara
authors.forename: M
authors.initials: M
authors.lastname: Lamana
authors.forename: M J
authors.initials: MJ
authors.lastname: Fernández Villalta
authors.forename: J M
authors.initials: JM
authors.lastname: Fernández-Rañada
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000328:Adult; D001787:Blood Group Incompatibility / Q000276:immunology*; D016026:Bone Marrow Transplantation / Q000276:immunology*; D004921:Erythropoietin / Q000627:therapeutic use*; D006461:Hemolysis / Q000187:drug effects* / Q000276:immunology*; D006801:Humans; D008297:Male
chemical_list: D000017:ABO Blood-Group System; D004921:Erythropoietin