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Peripheral Blood Stem Cells

Allogeneic peripheral blood hematopoietic stem cell transplantation: guidelines for red blood cell immuno-hematological assessment and transfusion practice

Bone Marrow Transplantation volume 25, pages 507–512 (2000)Cite this article

Abstract

Allogeneic peripheral blood hematopoietic stem cell transplantation (PBSCT) is presently being evaluated in a French randomized study comparing peripheral blood vs bone marrow. cases of potentially lethal acute hemolysis have recently been reported after allogeneic pbsct in the presence of a ‘minor’ abo incompatibility. patients were frequently transfused with recipient-compatible and donor-incompatible rbc and usually did not receive methotrexate in addition to cyclosporin a for graft-versus-host disease (gvhd) prophylaxis. in order to homogenize immuno-hematological (ih) assessment and transfusion practices within our protocol, we made proposals to 25 allo-transplant french centers on the following aspects: pre-inclusion ih assessment, ih exclusion criteria, transfusion rules, post-transplant ih surveillance and treatment of hemolysis. analysis of responses to our proposals led to the elaboration of guidelines which were approved and implemented by the french bone marrow transplantation society (sfgm). pre-inclusion ih testing includes mandatory detection and titration of anti-rbc allo-ab, as well as titration of anti-a and anti-b ab. the presence in the donor of an anti-a (group a or ab recipients), anti-b (group b or ab recipients) ab with a titer >1/32 or the presence of allo-Ab against Rh, Kell, Fya, Fyb, Jka, Jkb, Ss Ag present on recipient RBC is an exclusion criterion for the protocol. ABO and RhD compatibility of RBC blood products with both HSC donor and recipient is mandatory. A similar compatibility is also required for Rh (other than D) and Kell Ag. If not possible, compatibility of RBC blood products with the HSC donor is mandatory. Lastly, guidelines regarding post-transplantation IH follow-up as well as acute hemolysis treatment have been elaborated. The implementation of these guidelines should contribute to enhancing the quality of transfusion practice after PBSCT. Such an approach will be applied to other aspects of transfusion medicine in the setting of HSC transplantation. Bone Marrow Transplantation(2000) 25, 507–512.

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Acknowledgements

We wish to acknowledge JY Le Pennec, A Bussel, P Ladaique, O Agulles, P Perrier and A Schuhmacher for their exceptional contribution or helpful discussions. In particular, we wish to thank JY Le Pennec for providing standardized methods for RBC Ab titration and elution. We also would like to acknowledge the contribution of the following BMT centers: Angers: N Ifrah, B Coeffic; Besançon: JY Cahn, B Lamy; Bordeaux: JM Boiron, M Jeanne; Clermont Ferrand: H Curé, B Choufi; Créteil: M Kuentz, P Bierling, F Beaujean, F Charpentier, F Norol; Grenoble: JJ Sotto, JC Bensa; Hôtel Dieu (Paris): B Rio, MF Fruchart; Lille: JP Jouet, P Renom; Lyon: M Michallet, M Raba; Marseille: D Blaise, P Ladaique; Montpellier: JF Rossi, M Latry; Nancy: P Bordigoni, O Agulles, P Perrier, A Schuhmacher; Nantes: N Milpied, B David; Nice: D Gratecos, F Sanderson; Pitié Salpétrière (Paris): L Sutton, A Verdier; Rennes: PY Le Prisé; Saint Etienne: C Oriol; Saint-Louis (Paris): G Socié, A Bussel, C Schenmetzler, R Traineau; Strasbourg: B Lioure; Toulouse: M Attal, F Roubinet; Institut Gustave Roussy (Villejuif): JH Bourhis, JL Pico.

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Authors and Affiliations

  1. Unité de Médecine Transfusionnelle et d'Hémovigilance, Institut Gustave Roussy, Villejuif, France

    V Lapierre

  2. Hôpital Henri Mondor, Créteil, France

    M Kuentz

  3. Laboratoire d'Histocompatibilité et de Thérapeutique Immuno-Moléculaire, Établissement de Transfusion Sanguine de Franche-Comté, Besançon, France

    P Tiberghien

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Lapierre, V., Kuentz, M., Tiberghien, P. et al. Allogeneic peripheral blood hematopoietic stem cell transplantation: guidelines for red blood cell immuno-hematological assessment and transfusion practice. Bone Marrow Transplant 25, 507–512 (2000). https://doi.org/10.1038/sj.bmt.1702203

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