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Changes of isoagglutinin titres after ABO‐incompatible allogeneic stem cell transplantation
Author(s) -
Lee JeHwan,
Lee JungHee,
Choi SeongJun,
Kim Shin,
Seol Miee,
Kwon SeogWoon,
Park ChanJeoung,
Chi HyunSook,
Lee JungShin,
Kim WooKun,
Lee KyooHyung
Publication year - 2003
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.2003.04128.x
Subject(s) - abo blood group system , transplantation , haemolysis , pure red cell aplasia , medicine , immunology , isoantibodies , antibody , bone marrow
Summary. We investigated the changes in isoagglutinin titres in 62 patients who underwent ABO‐incompatible allogeneic stem cell transplantation. After major [and/or (±) minor] ABO‐incompatible transplantation, recipient‐derived isoagglutinins against donor‐type red blood cells (RBCs) disappeared more rapidly in unrelated recipients ( P = 0·006) and in patients with acute graft‐versus‐host disease (GVHD, P = 0·025) than in sibling recipients and in patients without acute GVHD respectively. Pure red cell aplasia (PRCA) developed in 10 out of 35 evaluable patients who underwent major (± minor) ABO‐incompatible transplantation, and the post‐transplant increase of isoagglutinin titres was a significant predictor for the occurrence of PRCA. In five out of 36 patients who underwent minor (and/or (±) major) ABO‐incompatible transplantation, donor‐derived isoagglutinins against recipient RBCs were detectable without clinically overt haemolysis. Isoagglutinin titres against ABO antigens absent both on recipient and donor RBCs decreased during the early post‐transplant period then rose subsequently in 24 out of 29 patients at (median) d 59 post transplant. Our study showed that changes in isoagglutinin titres might have clinical implications in the occurrence of immunohaematological complications such as PRCA or immune‐mediated haemolysis, and might reflect immunohaematological reconstitution after transplantation. Furthermore, our data regarding time to disappearance of recipient‐derived isoagglutinins against donor‐type RBCs after major ABO‐incompatible transplantation suggest the presence of a graft‐versus‐plasma cell effect.