Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Worel, N; Greinix, HT; Keil, F; Mitterbauer, M; Lechner, K; Fischer, G; Mayr, W; Höcker, P; Kalhs, P.
Severe immune hemolysis after minor ABO-mismatched allogeneic peripheral blood progenitor cell transplantation occurs more frequently after nonmyeloablative than myeloablative conditioning.
Transfusion. 2002; 42(10):1293-1301
Doi: 10.1046/j.1537-2995.2002.00209.x
Web of Science
PubMed
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- Co-Autor*innen der Med Uni Graz
- Greinix Hildegard
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- Abstract:
- Hemolysis as a result of donor-recipient minor ABO mismatching is a complication of allogeneic peripheral blood progenitor cell (PBPC) transplantation (PBPCT). The increased B-lymphocyte content of PBPC grafts and immunosuppressive regimens without methotrexate (MTX) may increase incidence and severity of this event. A total of 93 patients were analyzed after allogeneic PBPCT. In 25 (27%) cases, minor (n=21) or bidirectional (n=4) ABO mismatching was present. Of these, 15 patients received myeloablative and 10 received nonmyeloablative conditioning regimens. For GVHD, prophylaxis cyclosporin A (CsA) alone (n=2) or CsA with MTX (n=13) was given after myeloablative conditioning and CsA with mycophenolate mofetil (MMF) after nonmyeloablative conditioning (n=10). Hemolysis occurred in 4 out of 25 (16%) patients with minor or bidirectional ABO mismatching only. Three patients underwent nonmyeloablative conditioning and were given CsA with MMF, and one patient underwent myeloablative conditioning and was given CsA alone for GVHD prophylaxis. Hemolysis began 7 to 10 days after transplantation, and donor type alloantibodies were detectable concomitantly with recipients type RBCs. Patients receiving minor or bidirectional ABO-mismatched PBPC grafts and GVHD prophylaxis without MTX are at risk of hemolysis. Prophylactic interventions in patients before minor ABO-mismatched PBPCT not receiving MTX should be taken into consideration. Careful monitoring of hemolysis parameters during the first 15 days after PBPCT transplantation is mandatory.
- Find related publications in this database (using NLM MeSH Indexing)
- ABO Blood-Group System - genetics ABO Blood-Group System - immunology
- Adolescent -
- Adult -
- Aged -
- Anemia, Hemolytic - etiology Anemia, Hemolytic - immunology
- B-Lymphocytes - immunology B-Lymphocytes - transplantation
- Blood Group Incompatibility - blood
- Carcinoma, Renal Cell - therapy
- Erythrocyte Transfusion -
- Female -
- Graft vs Host Disease - etiology Graft vs Host Disease - mortality
- Hematologic Neoplasms - therapy
- Hemolysis -
- Humans -
- Immunosuppressive Agents - therapeutic use
- Kidney Neoplasms - therapy
- Male -
- Methotrexate - therapeutic use
- Middle Aged -
- Myelodysplastic Syndromes - therapy
- Myeloproliferative Disorders - therapy
- Peripheral Blood Stem Cell Transplantation - adverse effects Peripheral Blood Stem Cell Transplantation - mortality
- Prevalence -
- Rh-Hr Blood-Group System - genetics Rh-Hr Blood-Group System - immunology
- Survival Analysis -
- Transplantation Chimera -
- Transplantation Conditioning - methods Transplantation Conditioning - mortality
- Transplantation, Homologous - adverse effects Transplantation, Homologous - immunology