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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| Hauptverfasser: | , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
January 09 2024
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| In: |
Transfusion medicine and hemotherapy
Year: 2024, Pages: 1-4 |
| ISSN: | 1660-3818 |
| DOI: | 10.1159/000534272 |
| Online-Zugang: | Verlag, kostenfrei, Volltext: https://doi.org/10.1159/000534272
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| Verfasserangaben: | Lina S. Silva-Bermudez, Daniela Heidenreich, Stefan A. Klein, Patrick Wuchter, Harald Klüter, Sabine Kayser |
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| 245 | 1 | 0 | |a Prolonged thrombocytopenia and severe transfusion reaction after ABO-incompatible allogeneic hematopoietic stem cell transplantation in a patient with chronic myelomonocytic leukemia |c Lina S. Silva-Bermudez, Daniela Heidenreich, Stefan A. Klein, Patrick Wuchter, Harald Klüter, Sabine Kayser |
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| 520 | |a 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. | ||
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