title: Rapid engraftment after allogeneic ABO-incompatible peripheral blood progenitor cell transplantation complicated by severe hemolysis.
abstract: A patient with CML in accelerated phase received G-CSF-mobilized PBPC from an unrelated HLA genotypically matched donor. The blood groups of the patient and donor were bidirectionally incompatible. Hematologic recovery was rapid with > 500 PMN/microliter on day +9. Starting on day +5 bilirubin levels increased from 1.3 mg/dl up to a maximum of 18 mg/dl on day +14. Clinical signs and laboratory tests supported major hemolysis. Blood typing on day +16 revealed early blood-group change, consistent with donor-derived antibodies produced by passenger-lymphocytes which may have mediated severe hemolysis. The early onset and strong intensity of the hyperbilirubinemia could be a specific feature of ABO-incompatible allogeneic PBPC transplantation which would be difficult to differentiate from GVHD or VOD.
authors.affiliation: Department of Hematology/Oncology, Carl Gustav Carus Universität, Dresden, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Bornhäuser
authors.forename: R
authors.initials: R
authors.lastname: Ordemann
authors.forename: U
authors.initials: U
authors.lastname: Paaz
authors.forename: U
authors.initials: U
authors.lastname: Schuler
authors.forename: J
authors.initials: J
authors.lastname: Kömpf
authors.forename: K
authors.initials: K
authors.lastname: Hölig
authors.forename: G
authors.initials: G
authors.lastname: Ehninger
mesh_terms: D000017:ABO Blood-Group System; D000328:Adult; D006085:Graft Survival; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006461:Hemolysis; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D014184:Transplantation, Homologous
chemical_list: D000017:ABO Blood-Group System