Pure red cell aplasia following major ABO-incompatible allogeneic hematopoietic stem cell transplantation.
Six out of 20 patients undergoing a major ABO-incompatible allogeneic stem cell transplantation (allo-HSCT) developed pure red cell aplasia (PRCA), which did not show any effects on granulocyte and platelet engraftment, and incidence of grade II-IV aGVHD. All the 6 cases of PRCA were in blood group O recipients of grafts from blood group A donors (n = 5) or blood group B donor (n = 1), suggesting that donor/recipient pair (A/O) is associated with a high risk of PRCA after major ABO-incompatible allo-HSCT. Erythroid engraftment occurred spontaneously in four cases without specific intervention other than the RBC transfusion, which coincided with the decrease of isoagglutinin titers below 8, and the remaining 2 patients with prolonged erythroid aplasia( > 300 days) despite therapy with erythropoietin (EPO) were successfully treated by plasma exchange with donor-type plasma replacement. Cyclosporine did not appear to have played any role in causing PRCA in our patients, however, the occurrence of GVHD may facilitate the recovery of erythropoiesis.
Zhu
Kang-Er
KE
The First Affiliated Hospital, Medical College of Jinan University, Guangzhou 510630, China. tzhuker@jnu.edu.cn
Xu
Yang
Y
Wu
Dong
D
Zhong
Juan
J
D000017:ABO Blood-Group System; D000293:Adolescent; D000328:Adult; D016572:Cyclosporine / Q000627:therapeutic use; D004912:Erythrocytes / Q000473:pathology; D004920:Erythropoiesis; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012010:Red-Cell Aplasia, Pure / Q000209:etiology*; D014184:Transplantation, Homologous / Q000009:adverse effects; D016896:Treatment Outcome
D000017:ABO Blood-Group System; D016572:Cyclosporine