Impact of nonmyeloablative conditioning regimens on the occurrence of pure red cell aplasia after ABO-incompatible allogeneic haematopoietic stem cell transplantation.
OBJECTIVE
In the setting of major ABO-incompatible allogeneic haematopoietic stem cell transplantation (HSCT), pure red cell aplasia (PRCA) is linked to the persistence of host residual plasma cells secreting antidonor isohaemagglutinins (HA) after transplantation. There are conflicting results regarding the impact of the intensity of conditioning regimen on the occurrence of PRCA after major ABO-mismatched HSCT.


METHODS
To address this question, we compared two cases occurring after nonmyeloablative (NMA) and myeloablative (MA) HSCT and reviewed previous cases reported in the NMA setting.


CONCLUSIONS
We observed a delayed disappearance of antidonor HAs in the NMA setting, associated to a more prolonged period of red blood cells transfusion dependence than in the MA setting. In our case as in several others, the disappearance of antidonor HAs and resolution of PRCA were observed after reinforcement of the graft-versus-host effect (i.e. immunosuppression removal or donor leukocytes infusion).
Malfuson
J-V
JV
Department of Hematology, Hôpital Henri Mondor, Université Paris XII, Créteil, France.
Amor
R B
RB
Bonin
P
P
Rodet
M
M
Boccaccio
C
C
Pautas
C
C
Kuentz
M
M
Cordonnier
C
C
Noizat-Pirenne
F
F
Maury
S
S
D000017:ABO Blood-Group System / Q000009:adverse effects*; D000328:Adult; D051799:Delayed Graft Function; D005260:Female; D006086:Graft vs Host Disease; D006388:Hemagglutinins / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012010:Red-Cell Aplasia, Pure / Q000209:etiology*; D019172:Transplantation Conditioning / Q000009:adverse effects* / Q000379:methods*; D014184:Transplantation, Homologous / Q000009:adverse effects
D000017:ABO Blood-Group System; D006388:Hemagglutinins