Immune hemolysis involving non-ABO/RhD alloantibodies following hematopoietic stem cell transplantation.
We report two cases of severe alloimmune hemolysis after hematopoietic stem cell (HSC) transplant resulting from an anti-Jk(a). The time course of hemolysis and Jk phenotypes of the donor and recipient in the cases reported suggest that the antibody was produced by donor-derived passenger lymphocytes. Retrospective analysis of the blood bank records of all allogeneic HSC transplant patients at Barnes-Jewish Hospital from 1994 to 1999 suggests that the incidence of alloimmune hemolysis due to incompatibilities involving non-ABO or RhD red cell antigens is very low, approximately 1%. In one patient, the duration of hemolysis was shortened significantly by performing red cell exchange at the first sign of intravascular hemolysis.
Young
P P
PP
Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO 63110, USA.
Goodnough
L T
LT
Westervelt
P
P
Diersio
J F
JF
D000328:Adult; D000743:Anemia, Hemolytic / Q000209:etiology / Q000276:immunology*; D001787:Blood Group Incompatibility / Q000150:complications*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007518:Isoantibodies / Q000097:blood*; D007667:Kidd Blood-Group System / Q000276:immunology; D008297:Male; D014184:Transplantation, Homologous / Q000276:immunology
D007518:Isoantibodies; D007667:Kidd Blood-Group System