Premium
Resistant pure red cell aplasia after allogeneic stem cell transplantation with major ABO mismatch treated by escalating dose donor leukocyte infusion
Author(s) -
Verholen F.,
Stalder M.,
Helg C.,
Chalandon Y.
Publication year - 2004
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.2004.00320.x
Subject(s) - pure red cell aplasia , medicine , abo blood group system , stem cell , transplantation , rituximab , aplasia , donor lymphocyte infusion , immunology , gastroenterology , bone marrow , hematopoietic stem cell transplantation , lymphoma , biology , genetics
We report a case of pure red cell aplasia (PRCA) following allogeneic stem cell transplantation (SCT) with major ABO mismatch which proved resistant to all standard treatment options such as change in immunosuppressive treatment, high‐dose erythropoietin (EPO) or plasma exchange. We therefore proceeded to administer five cycles of Rituximab therapy, without success. Finally, escalating doses of donor‐derived leukocyte infusion (DLI) resolved the PRCA of our patient 415 d after bone‐marrow transplantation (BMT) and 140 d after the first infusion of donor leukocytes. A review of the literature shows the efficacy of various treatments; the role of DLI and other treatment options are discussed. Furthermore, the underlying pathophysiological mechanisms especially with regard to the role of NK cells in alloreactivity after allogeneic SCT are explained.