Blood Group Incompatibilities and Hemolytic Complications of Hematopoietic Cell Transplantation

O’Donnell, Margaret

doi:10.1002/9781118416426.ch78

Cited by 5 publications

(4 citation statements)

References 86 publications

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“…This and other studies emphasize the need for the transfusion medicine service to carefully assess pre-HCT and monitor closely all such patients post-HCT. 23-27 …”

Section: Discussionmentioning

confidence: 99%

“…6 In the case of ABO mismatched transplants, blood components were selected with the goal of reducing preventable complications. 23-27 Since patients with minor ABO mismatches are at risk for immune mediated hemolysis, Hb > 9.0 g/dl was maintained for these individuals during and immediately following the period of engraftment and recovery of blood cell counts. 6,26 RBC were transfused in quantities of 1 or 2 units, or more if clinically indicated.…”

Section: Methodsmentioning

confidence: 99%

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Transfusion support for matched sibling allogeneic hematopoietic stem cell transplantation (1993–2010): factors that predict intensity and time to transfusion independence

et al. 2018

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Background: Patients undergoing allogeneic hematopoietic stem cell transplant (HCT) require variable, often extensive transfusion support. Identification of factors that predict urgent, intensive, or special needs should improve management of these patients. Study Design and Methods: This is a retrospective study of red blood cell (RBC) and platelet transfusion support provided for sequential matched sibling donor (MSD) allogeneic transplants conducted at the Clinical Center, NIH, from 1993-2010. Factors potentially important for predicting quantity of RBC and platelet transfusions, and time to transfusion independence through Day 200 post-HCT were evaluated. Results: Subjects (n=800) received 10,591 RBC and 10,199 platelet transfusions. Multivariable analysis demonstrated that need for RBC pretransplant, CD34+ dose, transplant year, diagnostic category, and ABO match were significantly independently associated with quantity of RBC transfusions Days 0-30. Only pretransplant need for RBC, CD34+ dose and transplant year had significance during Days 0-100. Similar analyses for quantity of platelet transfusions demonstrated that for both Days 0-30 and 0-100, significant factors were need for platelet support pretransplant, CD34+ dose, transplant year, and transplant regimen. Of note, long term, during Days 101-200, only CD34+ dose remained significant for quantity of RBC and of platelet transfusions. Analysis of time to transfusion independence demonstrated that patients with ABO major mismatches required longer to achieve freedom from RBC transfusion support compared to identical matches or those with minor mismatches. Conclusion: Patient-specific factors including CD34+ dose and ABO match of the graft should be given particular consideration by transfusion services when planning support of patients receiving allogeneic HCT.

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“…This and other studies emphasize the need for the transfusion medicine service to carefully assess pre-HCT and monitor closely all such patients post-HCT. 23-27 …”

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Transfusion support for matched sibling allogeneic hematopoietic stem cell transplantation (1993–2010): factors that predict intensity and time to transfusion independence

et al. 2018

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“…17,19,22 AIHA caused by this mechanism can be seen in all types of allo-HSCT including CBT and haplo-HSCT, and even in ABO-matched transplantations. 23 The above mechanisms show that suppression of the plasma cells that are producing antibodies is the requirement for a successful transplantation.…”

Section: Discussionmentioning

confidence: 99%

“…26 Usually, AIHA occurs concomitantly with Epstein–Barr virus (EBV) and/or monoclonal gammopathy. 23 Rituximab can also be used for treating EBV and monoclonal gammopathy after transplantation. 27 Treating patients with rituximab can result in AIHA and monoclonal gammopathy resolving as well as EBV-DNA becoming undetectable.…”

Section: Discussionmentioning

confidence: 99%

Refractory autoimmune haemolytic anaemia following allogenic haematopoietic stem cell transplantation: successful treatment of rituximab

Huang

Zhu

et al. 2019

J Int Med Res

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Objective To investigate the effectiveness and safety of rituximab in treating autoimmune haemolytic anaemia (AIHA) after allogeneic haematopoietic stem cell transplantation (allo-HSCT). Methods Patients with refractory AIHA following allo-HSCT were treated once-weekly with rituximab 375 mg/m2 for a total of four doses. In an animal study, recipient CB6F1 mice were conditioned with busulfan/fludarabine and transplanted with splenocytes and T-cell-depleted bone marrow from C57Bl/6 mice. In this animal model, anti-CD20 monoclonal antibody (mAb) was evaluated to see if it could prevent graft versus host disease (GVHD). GVHD was monitored by body weight loss, GVHD clinical scores and the survival of each group of mice. Histopathological analyses of the skin, intestine, liver and lung were used to analyse the severity of GVHD. Results After rituximab therapy, refractory AIHA was resolved in all four patients as shown by increased haemoglobin levels. B-cell proportions were reduced with a relative increase of the proportions of T-cells following rituximab treatment. None of the four patients experienced chronic GVHD. In the animal model, anti-CD20 mAb treatment reduced GVHD. Conclusions Rituximab therapy deserves consideration for the treatment of post-HSCT patients with refractory AIHA. Further studies are needed to define the therapeutic role of this anti-CD20 mAb.

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ABO Mismatched Stem Cell Transplant and Related Complications

Sharma¹

2023

Basics of Hematopoietic Stem Cell Transplant

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Blood Group Incompatibilities and Hemolytic Complications of Hematopoietic Cell Transplantation

Cited by 5 publications

References 86 publications

Transfusion support for matched sibling allogeneic hematopoietic stem cell transplantation (1993–2010): factors that predict intensity and time to transfusion independence

Transfusion support for matched sibling allogeneic hematopoietic stem cell transplantation (1993–2010): factors that predict intensity and time to transfusion independence

Refractory autoimmune haemolytic anaemia following allogenic haematopoietic stem cell transplantation: successful treatment of rituximab

ABO Mismatched Stem Cell Transplant and Related Complications

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