Pure red cell aplasia after major ABO-incompatible bone marrow transplantation: two case reports of treatment with recombinant human erythropoietin.
A 34-year-old man with acute myelocytic leukemia (AML: MO) and a 32-year-old woman with AML: M2 developed pure red cell aplasia (PRCA) after receiving a major ABO incompatible bone marrow transplant (BMT). The first patient responded to recombinant human erythropoietin (rhEPO) therapy, while the second did not. The second patient also received methylprednisolone (m-PSL) but developed reticulocytosis and hemolysis after the administration of m-PSL. Plasmapheresis was then performed and the patient promptly recovered from hemolysis and PRCA. We conclude that close attention must be paid when treating PRCA following major ABO-incompatible BMT with rhEPO and m-PSL, as there is always the potential for massive hemolysis.
Fujisawa
S
S
Department of Hematology and Chemotherapy, Kanagawa Cancer Center, Yokohama-city, Japan.
Maruta
A
A
Sakai
R
R
Taguchi
J
J
Tomita
N
N
Ogawa
K
K
Kodama
F
F
Takahashi
K
K
Shibayama
S
S
Kobayashi
S
S
Ikuta
K
K
Okubo
T
T
D000017:ABO Blood-Group System / Q000276:immunology*; D000208:Acute Disease; D000328:Adult; D001787:Blood Group Incompatibility / Q000209:etiology* / Q000276:immunology; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007951:Leukemia, Myeloid / Q000150:complications / Q000628:therapy*; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000628:therapy*; D008297:Male; D018448:Models, Immunological; D011994:Recombinant Proteins; D012010:Red-Cell Aplasia, Pure / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology; D012074:Remission Induction; D014184:Transplantation, Homologous / Q000009:adverse effects*
D000017:ABO Blood-Group System; D011994:Recombinant Proteins; D004921:Erythropoietin