Multiple red cell alloantibodies, including anti‐Di^b, after allogeneic ABO‐matched peripheral blood progenitor cell transplantation

Abstract

Three kinds of non-ABO alloantibodies were detected, including anti-Dib described for the first time after HPCT. The rapid development of antibodies in the recipient despite intensive immunosuppression suggests their production by the donor cells primed by the RBC transfusion before HPC harvest. Their production by the residual host cells cannot be unequivocally excluded, however.

Red blood cell-incompatible allogeneic hematopoietic progenitor cell transplantation

“…57,59 Erker et al 26 studied the effects of differences in ABO, Rh and Kell systems on transplant outcomes for 143 patients. Fifteen patients had major Rhincompatible donors and 17 minor Rh-incompatible donors.…”

Transfusion Support Issues in Hematopoietic Stem Cell Transplantation

“…66,67 Alloimmunization Against Minor Red Blood Cell Antigens: The antibodies that cause PLS are temporary because they are derived from passenger lymphocytes that are not engrafted. When alloantibodies against RBCs are produced by the post-transplantation immune system, the antibodies may persist for several years, 68 and they may be produced by the engrafted cells of the immune system of the donor [69][70][71] or by the residual cells of the immune system of the recipient. 68,72,73 The antibodies produced may be against donor RBCs, residual recipient RBCs, or, in some cases, both.…”

A review of transfusion practice before, during, and after hematopoietic progenitor cell transplantation

“…47,62,[67][68][69][70][71] Immune hemolysis immediately after HPC transplantation infusion is from recipient-derived antierythrocyte antibodies (eg, major ABO mismatch), whereas delayed hemolysis is probably derived from donor blood-group antibodies (eg, minor ABO mismatch). Table 2 provides a guide to For personal use only.…”

“…Typically, the passenger lymphocyte syndrome involves ABO incompatibility, but hemolysis resulting from serologic incompatibility in the Rh, Kell, Duffy, or Kidd blood group systems has been reported. 62,[67][68][69][70] If hemolysis increases (rather than decreases) a few days after an HPC transplantation, the possibility of antibody production by the donor's lymphocytes should be considered. 1 Because of the higher lymphocyte content in a peripheral blood HPC graft, the theoretical risk of passenger lymphocyte syndrome is higher than in bone marrow HPC grafts, but reports of passenger lymphocyte syndrome with peripheral blood grafts are mostly anecdotal.…”