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Prolonged thrombocytopenia and severe transfusion reaction after ABO-incompatible allogeneic hematopoietic stem cell transplantation in a patient with chronic myelomonocytic leukemia

Introduction: Major ABO-incompatible allogeneic hematopoietic stem cell transplantation (allo-HCT) is a common practice and represents a challenging transfusion scenario. Prolonged thrombocytopenia with increased platelet transfusion needs is one of its reported adverse effects, and this has been li...

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Main Authors: Silva Bermudez, Lina Susana (Author) , Heidenreich, Daniela (Author) , Klein, Stefan (Author) , Wuchter, Patrick (Author) , Klüter, Harald (Author) , Kayser, Sabine (Author)
Format: Article (Journal)
Language:English
Published: January 09 2024
In: Transfusion medicine and hemotherapy
Year: 2024, Pages: 1-4
ISSN:1660-3818
DOI:10.1159/000534272
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1159/000534272
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Author Notes:Lina S. Silva-Bermudez, Daniela Heidenreich, Stefan A. Klein, Patrick Wuchter, Harald Klüter, Sabine Kayser
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Summary:Introduction: Major ABO-incompatible allogeneic hematopoietic stem cell transplantation (allo-HCT) is a common practice and represents a challenging transfusion scenario. Prolonged thrombocytopenia with increased platelet transfusion needs is one of its reported adverse effects, and this has been linked to the persistence of recipient anti-donor isoagglutinins. Case Presentation: A 55-year-old male patient, O Rh(D)-positive, with chronic myelomonocytic leukemia underwent major incompatible allo-HCT from a A Rh(D)-negative donor. He presented with prolonged thrombocytopenia and multiple transfusion reactions after A Rh(D)-negative platelet transfusions. Considering the outcomes of numerous examinations, we tested the anti-A1 titers, finding a significant persistence of anti-donor isoagglutinins. We limited platelet transfusions to blood group O Rh(D)-negative donors, which significantly decreased the requirement for platelet transfusions. In addition, the transfusion reactions ceased. Conclusion: In case of transfusion reactions against platelet products in major ABO-incompatible allo-HCT patients, isoagglutinin monitoring should be considered and a change in the platelet transfusion protocol may be beneficial in patients presenting high isotiters against recipient’s blood type.
Item Description:Gesehen am 22.02.2024
Physical Description:Online Resource
ISSN:1660-3818
DOI:10.1159/000534272

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