CD34+-enriched donor lymphocyte infusions in a case of pure red cell aplasia and late graft failure after major ABO-incompatible bone marrow transplantation

Bone Marrow Transplant. 1998 Sep;22(6):605-7. doi: 10.1038/sj.bmt.1701384.

Abstract

A variety of immunohematological complications may occur after ABO-incompatible BMT. We report a CML patient (blood group O) who received a BMT from an HLA-identical sibling (blood group AB). The transplant was followed by normal myeloid and megakaryocytic engraftment, but erythroblastopenia persisted for more than 200 days after BMT. By bone marrow culture studies, a complement-dependent serum inhibitor of hemopoiesis was detected, suggesting immunological inhibition of erythropoiesis. The patient was resistant to a number of treatments such as intravenous gamma-globulins, prednisolone and high-dose erythropoietin. Full engraftment with normal blood counts and marrow cellularity was achieved after two dose-escalating CD34+-enriched donor lymphocyte infusions (DLI). This experience suggests that CD34+-enriched DLI may be an effective treatment for patients with delayed engraftment or late graft failure due to major ABO-incompatibility.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • ABO Blood-Group System
  • Adult
  • Antigens, CD34 / blood*
  • Bone Marrow Transplantation / adverse effects*
  • Female
  • Graft Rejection / therapy*
  • Humans
  • Leukemia, Myeloid, Chronic-Phase / therapy
  • Lymphocyte Transfusion*
  • Male
  • Red-Cell Aplasia, Pure / etiology
  • Red-Cell Aplasia, Pure / therapy*
  • Tissue Donors

Substances

  • ABO Blood-Group System
  • Antigens, CD34