Summary of reported cases of hemolysis after minor (± major) ABO-incompatible peripheral blood hematopoietic stem cell transplantation
| Reference . | RBC group donor/ recipient . | Gender donor/ recipient . | Diagnosis . | CD34+/kg × 106 . | Donor anti-A and/or anti-B Ab . | Group of RBC transfused . | GvHD prophylaxis . | Day of hemolysis . | Hemolysis treatment (other than transfusion) and follow-up . |
|---|---|---|---|---|---|---|---|---|---|
| Laurencet et al14 | O/A | F/M | Myeloma | 5.0 | Anti-A: 1/64 anti-B: 1/128 | A | CSA alone | 12 | Steroids, forced diuresis Alive |
| Toren et al15 | O/A | F/M | ALL | 5.0 | Anti-A: 1/32 | NR | CSA alone | 8 | Steroids, blood exchange Alive |
| Oziel-Taieb et al16 | O/A | F/M | Myeloma | 3.5 | Anti-A: IgG: 1/8; IgM: 1/8 | A | CSA alone | 9 | No treatment reported Death day 20 |
| Moog et al17 | A/B | M/M | AML | 10 | NR | O | CSA alone | 8 | Forced diuresis Alive |
| Lyding et al18 | A/B | M/F | Erythrophagocytic lymphohistiocytosis | 11.5 | NR | B | CSA and MTX: d + 1, d + 3, d + 6 | 13 | Steroids Severe acute hemolysis Death day 48 (multiorgan failure) |
| Fitzgerald et al19 | O/A | F/M | ALL | NR | NR | A | CSA alone | 9 | Steroids, plasmapheresis Severe acute hemolysis Death day 117 (infection + GvHD) |
| Salmon et al20 | O/A | F/M (mother) | AML | 12.23 | Anti-A: 1/2048 | O (from mother) | CSA alone | 8 | Steroids, plasmapheresis Death day 35 (massive gastrointestinal bleeding + liver failure + GvHD) |
| Reference . | RBC group donor/ recipient . | Gender donor/ recipient . | Diagnosis . | CD34+/kg × 106 . | Donor anti-A and/or anti-B Ab . | Group of RBC transfused . | GvHD prophylaxis . | Day of hemolysis . | Hemolysis treatment (other than transfusion) and follow-up . |
|---|---|---|---|---|---|---|---|---|---|
| Laurencet et al14 | O/A | F/M | Myeloma | 5.0 | Anti-A: 1/64 anti-B: 1/128 | A | CSA alone | 12 | Steroids, forced diuresis Alive |
| Toren et al15 | O/A | F/M | ALL | 5.0 | Anti-A: 1/32 | NR | CSA alone | 8 | Steroids, blood exchange Alive |
| Oziel-Taieb et al16 | O/A | F/M | Myeloma | 3.5 | Anti-A: IgG: 1/8; IgM: 1/8 | A | CSA alone | 9 | No treatment reported Death day 20 |
| Moog et al17 | A/B | M/M | AML | 10 | NR | O | CSA alone | 8 | Forced diuresis Alive |
| Lyding et al18 | A/B | M/F | Erythrophagocytic lymphohistiocytosis | 11.5 | NR | B | CSA and MTX: d + 1, d + 3, d + 6 | 13 | Steroids Severe acute hemolysis Death day 48 (multiorgan failure) |
| Fitzgerald et al19 | O/A | F/M | ALL | NR | NR | A | CSA alone | 9 | Steroids, plasmapheresis Severe acute hemolysis Death day 117 (infection + GvHD) |
| Salmon et al20 | O/A | F/M (mother) | AML | 12.23 | Anti-A: 1/2048 | O (from mother) | CSA alone | 8 | Steroids, plasmapheresis Death day 35 (massive gastrointestinal bleeding + liver failure + GvHD) |
RBC indicates red blood cell; Ab, antibody; CSA, cyclosporin A; ALL, acute lymphoid leukemia; NR, not reported; Ig, immunoglobulin; AML, acute myeloid leukemia; MTX, methotrexate; GvHD, graft-versus-host disease.
In addition, Bornhäuser et al21 have described a case of acute hemolysis occurring at day 5 after an unrelated peripheral blood hematopoietic stem cells transplantation with minor and major ABO incompatibility (donor B; recipient A). Immunohematologic assessment at time of hemolysis was not reported.
All cases described concern HLA identical sibling allograft except for Salmon et al.20 In this case, the donor was the recipient's mother who had a major HLA class II mismatch.