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Post-Transplant Events

Lack of isohemagglutinin production following minor ABO incompatible unrelated HLA mismatched umbilical cord blood transplantation

Bone Marrow Transplantation volume 38, pages 135–140 (2006)Cite this article

Abstract

While immune hemolysis due to donor isohemagglutinin (IH) production often complicates minor ABO incompatible peripheral blood hematopoietic stem cell transplantation (PBSCT), it is not known if this occurs with umbilical cord blood transplantation (UCBT). We compared IH production and hemolysis following minor ABO allogeneic PBSCT and UCBT. We reviewed 24 ABO minor incompatible allogeneic PBSCTs and 14 ABO minor incompatible UCBTs. Patients were evaluated for donor-derived IH by reverse ABO grouping. Evaluation of hemolysis was based on clinical and laboratory findings of anemia associated with increased RBC transfusion need, concomitant with the appearance of donor-derived IH. Of the 24 ABO minor incompatible allogeneic PBSCTs, 15 produced donor-derived IH from 6 to 88 days following transplantation, with seven of 15 patients exhibiting clinically evident hemolysis. There was no significant difference in days to leukocyte engraftment or infused CD34 cells in patients with or without donor-derived IH. None of the 14 patients receiving ABO incompatible UCBTs showed evidence of donor-derived IH following transplantation with a median follow-up of 60 days. We conclude that donor IHs are not produced in patients undergoing minor ABO incompatible UCBTs suggesting fundamental immunologic differences between allogeneic PBSCT and UCBT.

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Authors and Affiliations

  1. Department of Internal Medicine (Division of Hematology/Oncology) and Pathology, University Hospitals of Cleveland & Case Western Reserve University School of Medicine, Cleveland, OH, USA

    M Snell, C Chau, D Hendrix, R Fox, K A Downes, R Creger, H Meyerson, M J Laughlin, H M Lazarus & R Yomtovian

  2. Department of Internal Medicine, Division of Hematology, Duke University Medical Center, Durham, NC, USA

    M J Telen

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  1. M Snell
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  2. C Chau
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  3. D Hendrix
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  4. R Fox
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  7. H Meyerson
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  8. M J Telen
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  9. M J Laughlin
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  10. H M Lazarus
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  11. R Yomtovian
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Correspondence to R Yomtovian.

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Snell, M., Chau, C., Hendrix, D. et al. Lack of isohemagglutinin production following minor ABO incompatible unrelated HLA mismatched umbilical cord blood transplantation. Bone Marrow Transplant 38, 135–140 (2006). https://doi.org/10.1038/sj.bmt.1705409

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  • DOI: https://doi.org/10.1038/sj.bmt.1705409

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