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Successful treatment of severe immune hemolytic anemia after allogeneic stem cell transplantation with bortezomib: report of a case and review of literature
Author(s) -
Hosoba Sakura,
Jaye David L.,
Cohen Cynthia,
Roback John D.,
Waller Edmund K.
Publication year - 2015
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.12815
Subject(s) - medicine , bortezomib , immunology , hematopoietic stem cell transplantation , autoimmune hemolytic anemia , rituximab , hemolytic anemia , anemia , transplantation , abo blood group system , donor lymphocyte infusion , immune system , aplastic anemia , antibody , bone marrow , multiple myeloma
Background Immune hemolytic anemia is a well‐known complication after allogeneic hematopoietic stem cell transplantation ( HSCT ). Posttransplant hemolytic anemia results in increased red blood cell transfusions and medical sequelae including iron overload. Case Report We present a case report of immune hemolytic anemia that occurred after allogeneic HSCT from an ABO major–mismatched, HLA ‐matched unrelated donor. The patient had high anti‐donor A type antibodies that were unresponsive to treatment with steroids and rituximab, resulting in persistent transfusion dependence. A detailed time course of anti‐ A titers, plasma cell content of the marrow, and B ‐cell content of the blood is presented. Treatment with bortezomib, a protease inhibitor, eliminated residual host‐type plasma cells secreting anti‐ A and restored normal donor‐derived erythropoiesis. Conclusion This report, and a review of literature for treatment of immune hemolytic anemia after allogeneic HSCT , supports the utility of bortezomib as plasma cell–targeted therapy in this setting.