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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.

transfusion

Successful treatment of severe immune hemolytic anemia after allogeneic stem cell transplantation with bortezomib: report of a case and review of literature