Transfusion Requirements after HLA‐Identical Marrow Transplantation in 82 Patients with Aplastic Anemia

Abstract

Red blood cell (RBC) and platelet (PLT) transfusion requirements during the first 13 weeks after HLA-identical marrow transplantation were studied in 82 patients with aplastic anemia. On the average, patients were given 9 units of RBCs (1-82) and 44 units of PLTS (6-468). The greatest need for support was during the first 4 weeks postgrafting. A multivariate statistical analysis of 22 variables showed that RBC and PLT requirements increased with age. In addition, RBC requirements increased if the patient had isohemagglutinins against the marrow donor's RBC, i.e., if the marrow transplant was across a major ABO barrier.

Changes of isoagglutinin titres after ABO‐incompatible allogeneic stem cell transplantation

“…Although ABO incompatibility between donor and recipient has not had a dramatic impact in allogeneic stem cell transplantation (Buckner et al, 1978;Bensinger et al, 1982), it can cause several immediate and delayed immunohaematological complications, which are related to the isoagglutinins against ABO antigens on the recipient and/or donor RBCs (Gale et al, 1977;Lasky et al, 1983;Wulff et al, 1983;Petz, 1987;Klumpp, 1991;Mehta et al, 1996). To investigate the clinical relevance of the changes in isoagglutinin titres after ABO-incompatible transplantation, we classified the isoagglutinins into three groups according to their relationship with ABO antigens on recipient and/or donor RBCs: (i) recipient-derived isoagglutinins against donor-type RBCs in major (± minor) ABO-incompatible allogeneic stem cell transplantation; (ii) donor-derived isoagglutinins against recipient RBCs in minor (± major) ABO-incompatible transplantation; and (iii) isoagglutinins against ABO antigens absent both on recipient and donor RBCs.…”