Early and fatal immune haemolysis after so-called 'minor' ABO-incompatible peripheral blood stem cell allotransplantation.
A 38-year-old man, blood group A+, was allotransplanted for multiple myeloma from his fully matched sister, blood group O+. Anti-A antibodies IgG and IgM titres of the donor were low. Allogeneic peripheral blood stem cells were harvested by leukapheresis after subcutaneous administration of G-CSF. Rapid engraftment occurred since 5.6 x 10(9)/l leukocytes were achieved on day +9 post-transplant. At this time a severe immune haemolytic syndrome occurred and direct antiglobulin test was positive (IgG and C3d). Elution showed an anti-A specificity. Evolution was rapidly unfavourable related to multiorgan failure. The patient died on day +20 post-transplant.
Oziel-Taieb
S
S
Institut Paoli-Calmettes, Bone Marrow Transplant Unit, Marseille, France.
Faucher-Barbey
C
C
Chabannon
C
C
Ladaique
P
P
Saux
P
P
Gouin
F
F
Gastaut
J A
JA
Maraninchi
D
D
Blaise
D
D
D000017:ABO Blood-Group System / Q000276:immunology*; D000328:Adult; D001787:Blood Group Incompatibility / Q000150:complications*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006461:Hemolysis; D006801:Humans; D008297:Male; D014184:Transplantation, Homologous
D000017:ABO Blood-Group System