title: Red blood cell support and alloimmunization rate against erythrocyte antigens in patients undergoing hematopoietic stem cell transplantation.
abstract: We retrospectively analyzed red blood cell (RBC) support and alloimmunization rate in 218 consecutive patients - 128 from the Pediatric Department and 90 from the adult Hematology Department - undergoing hematopoietic stem cell transplantation (HSCT) between 1994 and 2000. In the pre-HSCT period, the pediatric patients undergoing auto-HSCT required more RBC support. In the post-HSCT period, pediatric patients transplanted with an unrelated donor required more RBC support (median 13.5 U/10 kg bw) than patients receiving HSCT from a related donor (median 6 U/10 kg bw) or from an autologous source (median 4 U/10 kg bw, P=0.0004). In the pre-HSCT period, 159 out of 218 patients (73%) received a total of 1843 RBC units, with an overall median of 9 U/patient over a median of 24 months (range 4-62); 10 patients (6%) developed a total of 12 alloantibodies, with an alloimmunization rate of 5.4/1000 RBC units. In the post-HSCT period, all but three patients were given a total of 2420 RBC units, with an overall median of 6 U/patient over a median of 4 months (range 1-18); all but one of the pre-existing alloantibodies disappeared and three patients (1%) developed new alloantibodies with an alloimmunization rate of 1.2/1000 RBC units. These newly produced alloantibodies (one anti-M and two anti-E) were detected at +58, +90 and +210 days after HSCT. These findings might suggest a different approach to alloantibody screening tests in patients receiving HSCT, with a subsequent reduction of costs and laboratory workload.
authors.affiliation: Servizio di Immunoematologia e Trasfusionale, Unità di Aferesi, Ospedale San Gerardo dei Tintori, Via Donizetti 106, 20052 Monza, MI, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Perseghin
authors.forename: A
authors.initials: A
authors.lastname: Balduzzi
authors.forename: S
authors.initials: S
authors.lastname: Galimberti
authors.forename: M
authors.initials: M
authors.lastname: Dassi
authors.forename: V
authors.initials: V
authors.lastname: Baldini
authors.forename: M G
authors.initials: MG
authors.lastname: Valsecchi
authors.forename: P
authors.initials: P
authors.lastname: Pioltelli
authors.forename: S
authors.initials: S
authors.lastname: Bonanomi
authors.forename: P
authors.initials: P
authors.lastname: Faccini
authors.forename: A
authors.initials: A
authors.lastname: Rovelli
authors.forename: E M
authors.initials: EM
authors.lastname: Pogliani
authors.forename: C
authors.initials: C
authors.lastname: Uderzo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000917:Antibody Formation; D001789:Blood Group Antigens; D002648:Child; D002675:Child, Preschool; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data*; D004912:Erythrocytes / Q000276:immunology*; D005260:Female; D019337:Hematologic Neoplasms / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D007518:Isoantibodies; D007519:Isoantigens; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D001789:Blood Group Antigens; D007518:Isoantibodies; D007519:Isoantigens