title: Persistent complement-dependent anti-AnWj in a lymphoproliferative disorder: a case study and review.
abstract: AnWj is a high-incidence antigen present on the red blood cells (RBCs) of greater than 99 percent of the general population. A 58-year-old man underwent autologous hematopoietic stem cell transplantation (HSCT) for stage IVa mantle cell lymphoma. This procedure was complicated by failure to engraft, necessitating ongoing support with blood components. After a 2-month period of uneventful transfusion support, the patient experienced increasingly severe reactions with fever and evidence of intravascular hemolysis, including hemoglobinuria. Testing revealed a complement-dependent anti-AnWj. Phenotyping confirmed the AnWj- phenotype. Anti-AnWj was persistent despite immunosuppression, including treatment with allogeneic HSCT. Of interest, the pathogenesis of the downregulation of the graft AnWj in this patient is unclear.
authors.affiliation: Australian Centre for Blood Diseases, Monash University, Alfred Medical Research and Education Precinct, 89 Commercial Road, Melbourne, Victoria 3004, Australia.
authors.forename: G
authors.initials: G
authors.lastname: Grigoriadis
authors.forename: J
authors.initials: J
authors.lastname: Condon
authors.forename: K
authors.initials: K
authors.lastname: Green
authors.forename: M A
authors.initials: MA
authors.lastname: Anderson
authors.forename: M
authors.initials: M
authors.lastname: Borosak
authors.forename: E
authors.initials: E
authors.lastname: Wood
mesh_terms: D000906:Antibodies / Q000378:metabolism; D000920:Antibody-Dependent Cell Cytotoxicity; D001789:Blood Group Antigens / Q000276:immunology*; D003165:Complement System Proteins / Q000276:immunology*; D017707:Erythrocyte Transfusion; D004912:Erythrocytes / Q000276:immunology*; D006084:Graft Rejection / Q000276:immunology*; D018380:Hematopoietic Stem Cell Transplantation; D006456:Hemoglobinuria / Q000276:immunology; D006461:Hemolysis / Q000276:immunology; D006801:Humans; D007165:Immunosuppression Therapy; D020522:Lymphoma, Mantle-Cell / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000276:immunology
chemical_list: D000906:Antibodies; D001789:Blood Group Antigens; D003165:Complement System Proteins