Treatment of Acute Myeloblastic Leukaemia in a Patient with Bombay Blood Type: A Case Report

Abstract

A 62-year-old female was admitted to our hospital with suspected acute leukaemia and after investigation we diagnosed acute myeloblastic leukaemia (AML-M1). The patient's blood type was found to be the very rare Bombay type and surveillance of her relatives showed the same blood type in her male cousin on her mother's side. Alongside chemotherapy the patient received 4000 ml of frozen Bombay-type red cells, 1400 ml of concentrated red cells in manitol adenine phosphate solutions and 360 units of type O concentrated platelets without marked effects. The anti-H antibody was initially at 128 dilution but for unknown reasons increased to 2048 dilution after remission of AML-M1. About 3 months after hospitalization the patient died of Cryptococcus neoformans pneumonia despite strict precautions against infection. Although AML-M1 is a common adult leukaemia and is chemosensitive to anti-leukaemic drugs, neither AML-M1 in a patient with Bombay-type red cells nor its treatment with chemotherapy and transfusion with type Oh frozen red cells have previously been reported.

Acute Hemolytic Transfusion Reaction in a Patient with Bombay Phenotype: Implications for ABO Grouping

“…Schricker et al [10] reported successful autologous transfusions in a patient undergoing heart surgery with Bombay blood group. Okamoto et al [11] reported a patient with acute myeloblastic anaemia who was treated with chemotherapy and multiple transfusions without any adverse event. Lin-Chu and Broadberr [12] opined that the weak isoagglutinins in para-Bombay phenotype may not be very clinically significant and that when para-Bombay blood is not available, the compati- Bombay blood group has been reported to be the cause of hemolytic disease of newborn (HDN) requiring exchange transfusion [13].…”