Erythropoietin in the treatment of delayed immune hemolysis of a major ABO-incompatible bone marrow transplant.
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.
López
J
J
Hermatology Department, Hospital de La Princesa, Madrid, Spain.
Steegmann
J L
JL
Pérez
G
G
Otero
M J
MJ
Berberana
M
M
Cámara
R
R
Lamana
M
M
Fernández Villalta
M J
MJ
Fernández-Rañada
J M
JM
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
D000017:ABO Blood-Group System; D004921:Erythropoietin