Acute Graft-versus-Host Disease Resulting from Normal Donor Blood Transfusions

Abstract

2 fatal cases of graft-versus-host disease (GvHD) occurred following blood product transfusions given to patients receiving standard chemotherapy for Hodgkin’s disease. GvHD was established by HLA typing, clinical course, and compatible skin biopsy. 23 cases of GvHD following transfusion of blood products from normal donors are also reviewed. It should be suspected when fever or rash appear 1–2 weeks after transfusion of unirradiated blood products into a compromised host or when pancytopenia following chemotherapy is prolonged or unexpectedly severe. Prevention of GvHD by irradiation of granulocytes, platelets and packed red blood cells given to immunosuppressed patients is recommended to prevent this often fatal disease

IgE Allotypes in Sera of Mice with Autoimmune Diseases and in Mice with Graft-versus-Host Disease after Transfusion or Bone Marrow Transplantation

“…Our observations suggest that IgE is produced mainly by the do nor B cells in BMT-GVHD, the IgE allotype is a useful marker of mixed chimerism in GVHD. On the other hand, some types o f PT-GVHD [21][22][23] induced by the injection of parental lymphocytes into nonirradiated FI mice show production of autoantibodies and stimulatory pathologic symptoms, such as weight loss, aplastic anemia and hypo-gammaglobulinemia. In humans, increased IgE levels after GVHD in allogeneic BMT has been described by several investigators [24.…”

Guidelines on the use of irradiated blood components prepared by the British Committee for Standards in Haematology blood transfusion task force

“…TA‐GvHD is a very rare but usually fatal complication following transfusion of lymphocyte‐containing blood components. Although the first reports concerned cases where viable allogeneic lymphocytes had been transfused into immunosuppressed recipients (von Fliedner et al , 1982; Burns et al , 1984; Anderson & Weinstein, 1990), it became apparent that non‐immunosuppressed patients could also experience this problem, particularly if the blood components they received came from an HLA haploidentical unrelated donor or family member (Ohto et al , 1992; Aoun et al , 2003; Serefhanoglu et al , 2005; Triulzi et al , 2006; Agbaht et al , 2007).…”

Transfusion‐associated graft‐versus‐host disease

“…The majority of cases of TA‐GVHD have been reported in patients with haematological malignancies (Kessinger et al , 1987). Patients with Hodgkin's disease, with its associated immune deficiency state, are at highest risk of developing this disease (Dinsmore et al , 1980; von Fliedner et al , 1982; Burns et al , 1984; Decoste et al , 1990). Patients with other diseases, such as the acute leukaemias, that are treated with intensive chemotherapy have been reported to develop TA‐GVHD (Lowenthal et al , 1981; Nikoskelainen et al , 1983).…”