A case report of multiple-transfused aplastic anemia complicated by hemolysis and delayed neutrophil recovery after bone marrow transplantation

Yoshiki Akatsuka, H. Maeda, S. Tsuzuki, T. Sugihara, S. Minami, Y. Kodera, K. Koike

Research output: Contribution to journalArticle

Abstract

The authors report an 18-year-old female who developed severe hemolytic reaction and delayed neutrophil recovery after bone marrow transplantation (BMT) for aplastic anemia from her HLA-identical sibling. She had received much transfusion (61 units of red blood cells including 4 units of fresh whole blood from her parents and 350 units of platelets) for 12 years before BMT. To prevent graft rejection, she received an intensified preparative regimen consisted of cyclophosphamide 200 mg/kg followed by 5 Gy total body irradiation and 5 Gy total lymphoid irradiation. Prophylaxis for GVHD was short term methotrexate and cyclosporin-A. Despite of the removal of the red cells from the marrow, marked hemolytic reaction caused by antibodies directed to rh" (E) and hr' (c) red cell antigens was observed when rh" (E) and hr' (c) positive donor erythroid began to recover. The recovery of neutrophils, especially the fraction of segmented cells was also delayed. Flow cytometry showed that the serially collected patient's sera reacted to neutrophils derived from both patient's blood on the 64th post-transplant day and the donor's blood. The reactivity was strongest in pre-BMT sera. We conclude that residual antibodies sensitized before BMT are a major cause of these hematological problems.

Original languageEnglish
Pages (from-to)322-327
Number of pages6
Journal[Rinshō ketsueki] The Japanese journal of clinical hematology
Volume33
Issue number3
Publication statusPublished - 01-01-1992

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Aplastic Anemia
Hemolysis
Bone Marrow Transplantation
Neutrophils
Lymphatic Irradiation
Antibodies
Whole-Body Irradiation
Graft Rejection
Blood Donors
Serum
Methotrexate
Cyclophosphamide
Cyclosporine
Siblings
Flow Cytometry
Blood Platelets
Erythrocytes
Parents
Bone Marrow
Tissue Donors

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Akatsuka, Yoshiki ; Maeda, H. ; Tsuzuki, S. ; Sugihara, T. ; Minami, S. ; Kodera, Y. ; Koike, K. / A case report of multiple-transfused aplastic anemia complicated by hemolysis and delayed neutrophil recovery after bone marrow transplantation. In: [Rinshō ketsueki] The Japanese journal of clinical hematology. 1992 ; Vol. 33, No. 3. pp. 322-327.
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A case report of multiple-transfused aplastic anemia complicated by hemolysis and delayed neutrophil recovery after bone marrow transplantation. / Akatsuka, Yoshiki; Maeda, H.; Tsuzuki, S.; Sugihara, T.; Minami, S.; Kodera, Y.; Koike, K.

In: [Rinshō ketsueki] The Japanese journal of clinical hematology, Vol. 33, No. 3, 01.01.1992, p. 322-327.

Research output: Contribution to journalArticle

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AU - Akatsuka, Yoshiki

AU - Maeda, H.

AU - Tsuzuki, S.

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AU - Minami, S.

AU - Kodera, Y.

AU - Koike, K.

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