Transfusion management of an IgA deficient patient with anti-IgA and incidental correction of IgA deficiency after allogeneic bone marrow transplantation.
A patient with multiple myeloma was noted to have an IgA deficiency during investigation of a possible transfusion reaction due to IgA deficiency and anti-IgA. Because of the patient's age, otherwise good health, and early stage of disease, he was enrolled in a research treatment protocol that involved an allogeneic bone marrow transplant (BMT). The BMT successfully put the patient in complete remission from his multiple myeloma and corrected his IgA deficiency. Class-specific IgG anti-IgA antibody that had been identified prior to BMT was no longer detectable in his plasma. Anaphylactic transfusion reactions were successfully avoided by using a combination of IgA-deficient and washed blood components including the marrow graft, and IgA-reduced intravenous immunoglobulin.
Rogers
R L
RL
Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston 29425, USA.
Javed
T A
TA
Ross
R E
RE
Virella
G
G
Stuart
R K
RK
Frei-Lahr
D
D
D000328:Adult; D000888:Antibodies, Anti-Idiotypic / Q000378:metabolism; D001803:Blood Transfusion; D016026:Bone Marrow Transplantation / Q000276:immunology*; D006801:Humans; D017098:IgA Deficiency / Q000628:therapy*; D007070:Immunoglobulin A / Q000276:immunology; D008297:Male; D009101:Multiple Myeloma / Q000628:therapy*
D000888:Antibodies, Anti-Idiotypic; D007070:Immunoglobulin A