Rituximab for prevention of delayed hemolytic transfusion reaction in sickle cell disease.
Delayed hemolytic transfusion reaction (DHTR), a life-threatening transfusion complication in sickle cell disease (SCD), is characterized by a marked hemoglobin drop with destruction of both transfused and autologous red blood cells (RBCs) and exacerbation of SCD symptoms. One mechanism of RBCs destruction is auto-antibody production secondary to transfusion. As rituximab specifically targets circulating B cells, we thought that it could be beneficial in preventing this immune-mediated transfusion complication. We report the case of a SCD patient who previously experienced DHTR with auto-antibodies and who needed a new transfusion. DHTR recurrence was successfully prevented by rituximab administration prior transfusion, supporting the safe use of rituximab to prevent DHTR in SCD patients as a second line approach when other measures failed.
Etablissement Français du Sang, Ile de France, Hôpital Henri Mondor, Créteil, France. france.noizat-pirenne@efs.sante.fr
F
F
Noizat-Pirenne
D
D
Bachir
P
P
Chadebech
M
M
Michel
A
A
Plonquet
J-C
JC
Lecron
F
F
Galactéros
P
P
Bierling
D000328:Adult; D000744:Anemia, Hemolytic, Autoimmune / Q000097:blood / Q000209:etiology / Q000276:immunology / Q000628:therapy*; D000755:Anemia, Sickle Cell / Q000097:blood / Q000150:complications / Q000276:immunology / Q000628:therapy*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D058846:Antibodies, Monoclonal, Murine-Derived; D001323:Autoantibodies / Q000097:blood; D001402:B-Lymphocytes / Q000276:immunology / Q000378:metabolism; D017707:Erythrocyte Transfusion / Q000009:adverse effects; D004912:Erythrocytes / Q000276:immunology / Q000378:metabolism; D006461:Hemolysis / Q000187:drug effects* / Q000276:immunology; D006801:Humans; D007155:Immunologic Factors; D000069283:Rituximab
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D001323:Autoantibodies; D007155:Immunologic Factors; D000069283:Rituximab