Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Post-Transplant Complications

Immune hemolysis involving non-ABO/RhD alloantibodies following hematopoietic stem cell transplantation

Bone Marrow Transplantation volume 27, pages 1305–1310 (2001)Cite this article

Abstract

We report two cases of severe alloimmune hemolysis after hematopoietic stem cell (HSC) transplant resulting from an anti-Jka. The time course of hemolysis and Jk phenotypes of the donor and recipient in the cases reported suggest that the antibody was produced by donor-derived passenger lymphocytes. Retrospective analysis of the blood bank records of all allogeneic HSC transplant patients at Barnes-Jewish Hospital from 1994 to 1999 suggests that the incidence of alloimmune hemolysis due to incompatibilities involving non-ABO or RhD red cell antigens is very low, approximately 1%. In one patient, the duration of hemolysis was shortened significantly by performing red cell exchange at the first sign of intravascular hemolysis. Bone Marrow Transplantation (2001) 27, 1305–1310.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Lopez A, de la Rubia J, Arriaga F et al. Severe hemolytic anemia due to multiple red cell alloantibodies after an ABO-incompatible allogeneic bone marrow transplant Transfusion 1998 38: 247–250

    Article  CAS  Google Scholar 

  2. Abou-Elella AA, Camarillo TA, Allen MB et al. Low incidence of red cell and HLA antibody formation by bone marrow transplant patients Transfusion 1995 35: 981–985

    Article  Google Scholar 

  3. Ting A, Pun A, Dodds AJ et al. Red cell alloantibodies produced after bone marrow transplantation Transfusion 1987 27: 145–147

    Article  CAS  Google Scholar 

  4. Worel N, Greinix B, Schneider M et al. Regeneration of erythropoiesis after related- and unrelated-donor BMT or peripheral blood HPC transplantation: a major ABO mismatch means problems Transfusion 2000 40: 543–550

    Article  CAS  Google Scholar 

  5. Chen FE, Owen I, Savage D et al. Late onset haemolysis and red cell autoimmunisation after allogeneic bone marrow transplant Bone Marrow Transplant 1997 19: 491–495

    Article  CAS  Google Scholar 

  6. Robertson V, Hill M, Bryant J et al. Anti-Jkb identified in Jkb positive recipient following T cell depleted bone marrow transplant Transfusion 1987 27: 525 (Abstr.)

    Article  Google Scholar 

  7. Myser T, Steedman M, Hunt K et al. A bone marrow transplant with an acquired anti Le(a): a case study Hum Immunol 1986 17: 102–106

    Article  CAS  Google Scholar 

  8. Leo A, Mytillineos J, Voso MT et al. Passenger lymphocyte syndrome with severe hemolytic anemia due to an anti-Jka after allogeneic PBPC transplantation Transplantation 2000 40: 632–636

    CAS  Google Scholar 

  9. Hows J, Beddow K, Gordon-Smith E et al. Donor-derived red blood cell antibodies and immune hemolysis after allogeneic bone marrow transplantation Blood 1986 1: 177–181

    Google Scholar 

  10. Ramesy G . Red cell antibodies arising from solid organ transplants Transfusion 1996 31: 76–86

    Article  Google Scholar 

  11. Harmening DM . Modern Blood Banking and Transfusion Practices, 3rd edn FA Davis Company: Philadelphia 1994 pp 175–177

    Google Scholar 

  12. Ramsey G, Larson P . Loss of red cell alloantibodies over time Transfusion 1988 28: 162–165

    Article  CAS  Google Scholar 

  13. Ramsey G, Smietana SJ . Long-term follow-up testing of red cell alloantibodies Transfusion 1994 34: 122–124

    Article  CAS  Google Scholar 

  14. Schonewille H, Haak HL, van Zijl AM . RBC antibody persistence Transfusion 2000 40: 1127–1131

    Article  CAS  Google Scholar 

  15. Bejrachandra S, Chandanayingyong D . Unexpected red cell antibodies in donors and patients at Siriraj Hospital S Asian J Trop Med Pub Health 1979 10: 204–206

    CAS  Google Scholar 

  16. Pereira A, Monteagudo J, Rovira M et al. Anti-K1 of the IgA class associated with Morganella morganii infection Transfusion 1989 29: 549–551

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The authors are grateful to Drs Lublin and Lorenz for the careful review of this manuscript and the many helpful suggestions.

Author information

Authors and Affiliations

  1. Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO, USA

    PP Young, LT Goodnough & JF DiPersio

  2. Department of Internal Medicine, Washington University School of Medicine, St Louis, MO, USA

    LT Goodnough, P Westervelt & JF DiPersio

  3. Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA

    JF DiPersio

Authors
  1. PP Young
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. LT Goodnough
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P Westervelt
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. JF DiPersio
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Young, P., Goodnough, L., Westervelt, P. et al. Immune hemolysis involving non-ABO/RhD alloantibodies following hematopoietic stem cell transplantation. Bone Marrow Transplant 27, 1305–1310 (2001). https://doi.org/10.1038/sj.bmt.1703074

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1703074

Keywords

This article is cited by

Search

Advanced search

Quick links