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Allogeneic hematopoietic stem cell transplantations (HSCTs) represent a curative strategy for treating hematologic malignancies yet bear dangerous and frequently life-threatening complications including the development of graft-versus-host disease.Here, we present a case of a patient that suffered from relapsed/refractory multiple myeloma, a hematologic neoplasm characterized by clonal proliferation of malignant plasma cells in the bone marrow. During the course of his disease, the patient underwent consecutive allogeneic HSCTs, during which he developed a clinical meaningful and hitherto unreported ABO subgroup incompatibility, leading to persistent hemolysis. Testing for ABO subgroups during donor selection, especially after consecutive allogeneic HSCTs, may therefore aid to prevent these complications. K E Y W O R D SA1/A2 subtyping of blood group A, ABO incompatibility, allogeneic hematopoietic stem cell transplantation, hemolysis CASE REPORTThe patient was initially diagnosed with a standard risk multiple myeloma (MM) in January 2013 (Table 1A). Partial response (PR) was achieved after three cycles of induction therapy with lenalidomide, doxorubicin, and dexamethasone, which was administered within the randomized multicenter phase III trial (DSMM XIV study) by theThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.