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Red blood cell support and alloimmunization rate against erythrocyte antigens in patients undergoing hematopoietic stem cell transplantation

Bone Marrow Transplantation volume 32, pages 231–236 (2003)Cite this article

Summary:

We retrospectively analyzed red blood cell (RBC) support and alloimmunization rate in 218 consecutive patients – 128 from the Pediatric Department and 90 from the adult Hematology Department – undergoing hematopoietic stem cell transplantation (HSCT) between 1994 and 2000. In the pre-HSCT period, the pediatric patients undergoing auto-HSCT required more RBC support. In the post-HSCT period, pediatric patients transplanted with an unrelated donor required more RBC support (median 13.5 U/10 kg bw) than patients receiving HSCT from a related donor (median 6 U/10 kg bw) or from an autologous source (median 4 U/10 kg bw, P=0.0004). In the pre-HSCT period, 159 out of 218 patients (73%) received a total of 1843 RBC units, with an overall median of 9 U/patient over a median of 24 months (range 4–62); 10 patients (6%) developed a total of 12 alloantibodies, with an alloimmunization rate of 5.4/1000 RBC units. In the post-HSCT period, all but three patients were given a total of 2420 RBC units, with an overall median of 6 U/patient over a median of 4 months (range 1–18); all but one of the pre-existing alloantibodies disappeared and three patients (1%) developed new alloantibodies with an alloimmunization rate of 1.2/1000 RBC units. These newly produced alloantibodies (one anti-M and two anti-E) were detected at +58, +90 and +210 days after HSCT. These findings might suggest a different approach to alloantibody screening tests in patients receiving HSCT, with a subsequent reduction of costs and laboratory workload.

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Acknowledgements

We gratefully acknowledge Mrs Joanna Upton for her linguistic assistance.

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Authors and Affiliations

  1. Servizio di Immunoematologia e Trasfusionale, Unità di Aferesi, Ospedale San Gerardo de' Tintori, Monza, Italy

    P Perseghin, M Dassi & V Baldini

  2. Clinica Pediatrica-Centro Trapianti di Midollo, Ospedale San Gerardo de' Tintori, Monza, Italy

    A Balduzzi, S Bonanomi, A Rovelli & C Uderzo

  3. Sezione di Statistica Medica-Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie, Università degli Studi di Milano-Bicocca, Italy

    S Galimberti & M G Valsecchi

  4. Sezione di Ematologia-Centro Trapianti di Midollo, Ospedale San Gerardo de' Tintori, Monza, Italy

    P Pioltelli, P Faccini & E M Pogliani

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  1. P Perseghin
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Perseghin, P., Balduzzi, A., Galimberti, S. et al. Red blood cell support and alloimmunization rate against erythrocyte antigens in patients undergoing hematopoietic stem cell transplantation. Bone Marrow Transplant 32, 231–236 (2003). https://doi.org/10.1038/sj.bmt.1704114

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