Resistant pure red cell aplasia after allogeneic bone marrow transplantation with major ABO mismatch treated by purified CD34+ cell infusion.
We report a case of pure red cell aplasia (PRCA) subsequent to an allogeneic bone marrow transplantation with a major ABO mismatch, which was resistant to the standard treatment options such as plasma exchange, erythropoietin and changes in the immunosuppressive treatment. Accordingly, two cycles of Rituximab therapy were administered without success. The patient had a chronic graft-vs.-host disease of the liver, which meant that an additional donor leukocyte infusion could not be introduced. Instead, purified CD34(+) cells were administered after fludarabine and antithymocyte globulin therapy. As a result, the PRCA was resolved and the antidonor isohemagglutinin titer became undetectable.
Woo
Hyun-Young
HY
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Min
Chang-Ki
CK
Lee
Se-Min
SM
Cho
Hyun-Sun
HS
Kim
Seong-Yong
SY
Lee
Seok
S
Lee
Jong-Wook
JW
Min
Woo-Sung
WS
Kim
Chun-Choo
CC
Kim
Yonggu
Y
D000017:ABO Blood-Group System; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived; D018952:Antigens, CD34 / Q000276:immunology*; D016026:Bone Marrow Transplantation; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D017708:Leukocyte Transfusion; D019300:Medical Errors; D012010:Red-Cell Aplasia, Pure / Q000097:blood / Q000188:drug therapy / Q000601:surgery*; D000069283:Rituximab; D014184:Transplantation, Homologous; D014740:Vidarabine / Q000031:analogs & derivatives / Q000627:therapeutic use
D000017:ABO Blood-Group System; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018952:Antigens, CD34; D004921:Erythropoietin; D000069283:Rituximab; D014740:Vidarabine; C024352:fludarabine