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Late onset immune pancytopenia following bone marrow transplantation
Author(s) -
Bashey Asad,
Owen Irene,
Lucas Geoffrey F.,
Amphlett Nigel W.,
Jones Margaret M.,
Lawal Adebayo,
McMullin MaryFrances,
Mahendra Prem,
Tyfield Linda A.,
Hows Jill M.
Publication year - 1991
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 - 10.1111/j.1365-2141.1991.tb04427.x
Subject(s) - pancytopenia , medicine , splenectomy , bone marrow , neutropenia , transplantation , evans syndrome , immunology , graft versus host disease , surgery , spleen , antibody , autoimmune hemolytic anemia , chemotherapy
Summary A 17‐year‐old boy developed autoimmune pancytopenia in the absence of chronic graft‐versus‐host disease 170 d after allogeneic bone marrow transplantation (BMT) from his HLA identical brother. The anaemia and thrombocytopenia responded to conventional immunosuppressive treatment, but the neutropenia was refractory to this and to splenectomy and subsequent removal of splenic remnant. Following total lymphoid irradiation the neutrophil count rose to low normal levels but thrombocytopenia and anaemia secondary to marrow hypoplasia required transfusion support. Bone marrow function was finally normalized by an additional transfusion of donor marrow without prior immunosuppressive therapy. We conclude that late onset immune pancytopenia post BMT caused by antibodies of probable donor origin may be life threatening in the absence of chronic graft‐versus‐host disease.