Mixed erythrocyte chimerism: implications for tolerance of the donor immune system to recipient non-ABO system red cell antigens.
We report a case of a minor degree of ABO incompatibility in a BMT recipient, demonstrating mixed RBC chimerism, who, late in the post-transplant period, developed a warm autoimmune hemolytic anemia and subsequently developed antibodies with donor-anti-recipient specificities for non-ABO system RBC antigens. While this implies a lack of tolerance of the donor immune system for recipient non-ABO system RBC antigens, other factors may be operating and should be evaluated before such a conclusion is reached. Underscored is the importance of obtaining pretransplant RBC antigen phenotypes on both the recipient and donor.
Wennerberg
A
A
Department of Pathology, School of Medicine, East Carolina University, Greenville, NC 27858, USA.
Backman
K A
KA
Gillerlain
C
C
Robertson
V
V
Jones
C
C
Joyner
T
T
D000328:Adult; D001787:Blood Group Incompatibility / Q000209:etiology*; D016026:Bone Marrow Transplantation / Q000276:immunology*; D002678:Chimera; D004912:Erythrocytes / Q000276:immunology*; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D006801:Humans; D007108:Immune Tolerance