title: Pure red cell aplasia after major ABO-incompatible bone marrow transplantation: two case reports of treatment with recombinant human erythropoietin.
abstract: 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.
authors.affiliation: Department of Hematology and Chemotherapy, Kanagawa Cancer Center, Yokohama-city, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Fujisawa
authors.forename: A
authors.initials: A
authors.lastname: Maruta
authors.forename: R
authors.initials: R
authors.lastname: Sakai
authors.forename: J
authors.initials: J
authors.lastname: Taguchi
authors.forename: N
authors.initials: N
authors.lastname: Tomita
authors.forename: K
authors.initials: K
authors.lastname: Ogawa
authors.forename: F
authors.initials: F
authors.lastname: Kodama
authors.forename: K
authors.initials: K
authors.lastname: Takahashi
authors.forename: S
authors.initials: S
authors.lastname: Shibayama
authors.forename: S
authors.initials: S
authors.lastname: Kobayashi
authors.forename: K
authors.initials: K
authors.lastname: Ikuta
authors.forename: T
authors.initials: T
authors.lastname: Okubo
mesh_terms: 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*
chemical_list: D000017:ABO Blood-Group System; D011994:Recombinant Proteins; D004921:Erythropoietin