Transient anti rhesus alloantibody produced by graft after non-myeloablative allogeneic stem cell transplant.
BACKGROUND
We report the case of a patient who received an allogeneic transplant with peripheral blood compatible ABO, Rhesus mismatched progenitor cells and who developed an asymptomatic transient anti Rhesus alloimmunisation.


METHODS
A 56-year-old man with renal cell carcinoma received a non-myeloablative allogeneic PBPC ABO compatible graft from his HLA-identical brother. Graft-versus-host disease prophylaxis consisted of cyclosporine alone. On day + 59, prior to any transfusion, a positive direct antiglobulin test (IgG++, C3d-) was detected. The indirect antiglobulin test (IAT) was considered doubtful, and IAT identification revealed the presence of an active anti Rhesus antibody (anti D specificity) in the patient's serum. This immunisation had no clinical consequence, with no acute hemolytic episode. Further monitoring showed negative antibody screening tests on day + 78.


CONCLUSIONS
To our knowledge this is the first reported case of transient anti Rh (D) allo-immunisation after non-myeloablative allogeneic peripheral blood progenitor cell (PBPC) transplant. The period of occurrence and the specificity of this antibody strongly suggest a donor cell origin.
Contentin
N
N
Department of Hematology, Centre Henri Becquerel, 1, rue d'Amiens, 76038 Rouen Cedex, France. nathalie.contentin@rouen.fnclcc.fr
Lenain
P
P
Chamouni
P
P
Hau
F
F
Bastit
D
D
Buchonnet
G
G
Tilly
H
H
D002292:Carcinoma, Renal Cell / Q000628:therapy*; D017707:Erythrocyte Transfusion; D006801:Humans; D007518:Isoantibodies / Q000097:blood*; D007680:Kidney Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012204:Rh-Hr Blood-Group System / Q000276:immunology*; D033581:Stem Cell Transplantation; D014184:Transplantation, Homologous
D007518:Isoantibodies; D012204:Rh-Hr Blood-Group System