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

Lee, Je‐Hwan; Lee, Jung‐Hee; Choi, Seong–Jun; Kim, Shin; Seol, Miee; Kwon, Sun Il; Park, Chan‐Jeoung; Chi, Hyun‐Sook; Lee, Jung Shin; Kim, Woo-Kun; Lee, Kyoo‐Hyung

doi:10.1046/j.1365-2141.2003.04128.x

Cited by 52 publications

(60 citation statements)

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“…In allogeneic haematopoietic-cell transplantation, major ABOincompatibility occurs when the recipient has naturally occurring anti-A or anti-B isohaemagglutinins against type A or type B antigens found on donor red blood cells (RBCs) (Benjamin et al, 1998;Worel et al, 2000;Rowley, 2001;Zaucha et al, 2002;Lee et al, 2003;Dodds, 2004;O'Donnell, 2004;Petz & Garratty, 2004). The intensity of transplant conditioning influences the length of time that the isohaemagglutinins persist post-transplant.…”

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Persistence of recipient plasma cells and anti‐donor isohaemagglutinins in patients with delayed donor erythropoiesis after major ABO incompatible non‐myeloablative haematopoietic cell transplantation

et al. 2005

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SummaryDelayed donor erythropoiesis and pure red‐cell aplasia (PRCA) complicate major‐ABO mismatched non‐myeloablative allogeneic stem‐cell transplantation. To characterize these events, we analysed red‐cell serology and chimaerism in lymphohaematopoietic lineages, including plasma cells and B cells, in 12 consecutive major‐ABO incompatible transplants following cyclophosphamide/fludarabine‐based conditioning. Donor erythropoiesis was delayed to more than 100 days in nine (75%) patients including six (50%) who developed PRCA. During PRCA, all patients had persistent anti‐donor isohaemagglutinins and recipient plasma cells (5–42%), while myeloid and T cells were completely donor in origin. In contrast, B‐cell chimaerism was frequently full‐donor when significant anti‐donor isohaemagglutinins persisted. Four patients with early mixed haematopoietic chimaerism and the prolonged presence of anti‐donor isohaemagglutinins and recipient plasma cells developed delayed‐onset (>100 days post‐transplant) red cell transfusion dependence and PRCA after myeloid chimaerism converted from mixed to full donor. These findings confirm that donor‐erythropoiesis is impacted by temporal disparities in donor immune‐mediated eradication of recipient lymphohaematopoietic cells during major‐ABO incompatibility and suggest that plasma cells are relatively resistant to graft‐versus‐host haematopoietic effects.

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confidence: 99%

Persistence of recipient plasma cells and anti‐donor isohaemagglutinins in patients with delayed donor erythropoiesis after major ABO incompatible non‐myeloablative haematopoietic cell transplantation

et al. 2005

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“…[1][2][3] Since blood group antigens are inherited independently of the human leukocyte antigen (HLA) complex, 4 ABO incompatibility between donor and recipient is observed in about 30% of HSCT. 5 Red cell incompatibility is classified according to whether donor's isohemagglutinins, isoantigens or both are incompatible with those of the recipient. Major ABO-incompatible HSCT recipients may experience delayed red cell recovery after transplantation because of persistent host isohemagglutinins that suppress donor's red cell hematopoiesis.…”

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confidence: 99%

Prolonged red cell aplasia after major ABO-incompatible allogeneic hematopoietic stem cell transplantation: removal of persisting isohemagglutinins with Ig-Therasorb® immunoadsorption

Rabitsch

Knöbl

Prinz

et al. 2003

Bone Marrow Transplant

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Summary:Delayed donor red cell engraftment and prolonged red cell aplasia (PRCA) are well-recognized complications of major ABO-incompatible myeloablative and nonmyeloablative hematopoietic stem cell transplantation (HSCT). There is an intense debate about the impact on outcome, severity of hemolysis, association with graft-versus-host disease and survival after blood group-incompatible stem cell transplantation. Therefore, therapeutic strategies should be considered to avoid these possible complications. We present five patients, who received allogeneic HSCT from human leukocyte antigen-identical donors for hematological malignancies, which were treated with IgTherasorb s immunoadsorption (five treatments/week) to remove persisting incompatible isohemagglutinins. After a median of 17 treatments (range 9-25), all the patients became transfusion independent with the presentation of donor's blood group. No side effects occurred during treatment. Ig-Therasorb s immunoadsorption seems to be a promising therapeutic method for rapid, efficient and safe elimination for persisting isohemagglutinins for patients with PRCA after allogeneic hematological stem cell transplantation.

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“…42,50,51 Other treatments include erythropoietin, 52 rituximab, 53,54 bortezomib, or all 3 options in combination. 43,55 Because PRCA is associated with high levels of isohemagglutinins, [44][45][46][47] a direct reduction of titers by plasma exchange may be effective in some patients. 47,56 Although the reduction of titers before the transplantation has been attempted to prevent PRCA, 57,58 knowing the actual effect of this approach is impossible.…”

Section: Major Abo Mismatchesmentioning

confidence: 99%

“…An increase in post-transplantation isohemagglutinin titers is also an important predisposing factor for PRCA. [44][45][46][47] PRCA may spontaneously resolve, 44,48 but treatment to reduce its duration is warranted to diminish the risk of iron overload from multiple RBC transfusions. 49 Therapy for PRCA includes bolstering the graft-vs-host effect either through withdrawal of immunosuppression 44 or with a donor infusion of leukocytes.…”

Section: Major Abo Mismatchesmentioning

confidence: 99%

Transfusion Support Issues in Hematopoietic Stem Cell Transplantation

Cohn

2015

Cancer Control

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on canvas printed with an image of myxofibrosarcoma with metastases to the artist's lung, 26" × 36". Minnesota, Minneapolis, Minnesota. Submitted March 27, 2014; accepted July 23, 2014. Address correspondence to Claudia S. Cohn, MD, PhD, D242 Mayo Memorial Building, MMC 609, 420 Delaware Street, South East, Minneapolis, MN 55455. E-mail: cscohn@umn antigen (HLA) matching remains an important predictor of success with HSCT; however, the ABO barrier is often crossed when searching for the most appropriate HLA match between donor and patient. Crossing the ABO barrier has little or no effect on overall outcomes; however, complications can arise due to antigenic incompatibility between the transplanted cells and the patient. From the Department of Laboratory Medicine and Pathology, University of1 This review will discuss the transfusion support of patients receiving HSCT, common transfusion-related complications that health care professionals will likely encounter, and the measures required to safely deliver blood components.HSCTs can be broadly divided into related allogeneic, unrelated allogeneic, and autologous transplantation. Hematopoietic progenitor cells (HPCs) for allogeneic transplantation come from 3 sources: apheresis-derived, mobilized peripheral blood pro- Transfusion Support Issues in Hematopoietic Stem Cell Transplantation

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

Cited by 52 publications

References 54 publications

Persistence of recipient plasma cells and anti‐donor isohaemagglutinins in patients with delayed donor erythropoiesis after major ABO incompatible non‐myeloablative haematopoietic cell transplantation

Persistence of recipient plasma cells and anti‐donor isohaemagglutinins in patients with delayed donor erythropoiesis after major ABO incompatible non‐myeloablative haematopoietic cell transplantation

Prolonged red cell aplasia after major ABO-incompatible allogeneic hematopoietic stem cell transplantation: removal of persisting isohemagglutinins with Ig-Therasorb® immunoadsorption

Transfusion Support Issues in Hematopoietic Stem Cell Transplantation

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