Removal of persisting isohaemagglutinins with Ig-Therasorb immunoadsorption after major ABO-incompatible non-myeloablative allogeneic haematopoietic stem cell transplantation.
BACKGROUND
Major ABO-incompatibility can be associated with haemolysis, prolonged red cell aplasia (PRCA) and higher peri-transplant mortality resulting from organ toxicity after conventional and non-myeloablative allogeneic haematopoietic stem cell transplantation. Different therapeutic strategies have been developed to allow erythroid reconstitution in these patients.


METHODS
We present three patients, who developed PRCA after non-myeloablative allogeneic haematological stem cell transplantation for haematological malignancies. The patients were treated with Ig-Therasorb immunoadsorption (five treatments per week) to remove persisting incompatible isohaemagglutinins.


RESULTS
Two patients became transfusion independent after 12 and 14 treatments. In one patient, however, no reduction of the isohaemagglutinin titres could be observed after 25 treatments, probably due to persistence of his underlying disease.


CONCLUSIONS
Although Ig-Therasorb immunoadsorption was effective in only two patients, it seems to be a promising therapeutic option for patients with PRCA after allogeneic non-myeloablative haematological stem cell transplantation.
Rabitsch
Werner
W
Department of Medicine I, Bone Marrow Transplantation Unit, University of Vienna, Vienna, Austria. werner.rabitsch@akh-wien.ac.at
Knöbl
Paul
P
Greinix
Hildegard
H
Prinz
Erika
E
Kalhs
Peter
P
Hörl
Walter H
WH
Derfler
Kurt
K
D000017:ABO Blood-Group System; D000328:Adult; D001787:Blood Group Incompatibility / Q000150:complications; D006388:Hemagglutinins / Q000378:metabolism*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007163:Immunosorbent Techniques; D008297:Male; D008875:Middle Aged; D012010:Red-Cell Aplasia, Pure / Q000209:etiology* / Q000628:therapy*
D000017:ABO Blood-Group System; D006388:Hemagglutinins