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

• Verfasst von: Silva Bermudez, Lina Susana [VerfasserIn]
• Verfasst von: Heidenreich, Daniela [VerfasserIn]
• Verfasst von: Klein, Stefan [VerfasserIn]
• Verfasst von: Wuchter, Patrick [VerfasserIn]
• Verfasst von: Klüter, Harald [VerfasserIn]
• Verfasst von: Kayser, Sabine [VerfasserIn]
• Titel: Prolonged thrombocytopenia and severe transfusion reaction after ABO-incompatible allogeneic hematopoietic stem cell transplantation in a patient with chronic myelomonocytic leukemia
• Verf.angabe: Lina S. Silva-Bermudez, Daniela Heidenreich, Stefan A. Klein, Patrick Wuchter, Harald Klüter, Sabine Kayser
• E-Jahr: 2024
• Jahr: January 09 2024
• Umfang: 4 S.
• Illustrationen: Illustrationen
• Fussnoten: Gesehen am 22.02.2024
• Titel Quelle: Enthalten in: Transfusion medicine and hemotherapy
• Ort Quelle: Basel : Karger, 2003
• Jahr Quelle: 2024
• Band/Heft Quelle: (2024) online ahead of print
• ISSN Quelle: 1660-3818
• DOI: doi:10.1159/000534272
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1881441563

Abstract

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.