Impact of nonmyeloablative conditioning regimens on the occurrence of pure red cell aplasia after ABO-incompatible allogeneic haematopoietic stem cell transplantation
Article first published online: 27 NOV 2006
Volume 92, Issue 1, pages 85–89, January 2007
How to Cite
Malfuson, J.-V., Amor, R. B., Bonin, P., Rodet, M., Boccaccio, C., Pautas, C., Kuentz, M., Cordonnier, C., Noizat-Pirenne, F. and Maury, S. (2007), Impact of nonmyeloablative conditioning regimens on the occurrence of pure red cell aplasia after ABO-incompatible allogeneic haematopoietic stem cell transplantation. Vox Sanguinis, 92: 85–89. doi: 10.1111/j.1423-0410.2006.00865.x
- Issue published online: 27 NOV 2006
- Article first published online: 27 NOV 2006
- Received: 10 June 2006, revised 18 September 2006, accepted 5 October 2006
- ABO compatibility;
- allogeneic haematopoietic stem cell transplantation;
- nonmyeloablative conditioning regimen;
- pure red cell aplasia
Background and Objectives In the setting of major ABO-incompatible allogeneic haematopoietic stem cell transplantation (HSCT), pure red cell aplasia (PRCA) is linked to the persistence of host residual plasma cells secreting antidonor isohaemagglutinins (HA) after transplantation. There are conflicting results regarding the impact of the intensity of conditioning regimen on the occurrence of PRCA after major ABO-mismatched HSCT.
Material and Methods To address this question, we compared two cases occurring after nonmyeloablative (NMA) and myeloablative (MA) HSCT and reviewed previous cases reported in the NMA setting.
Results and Conclusions We observed a delayed disappearance of antidonor HAs in the NMA setting, associated to a more prolonged period of red blood cells transfusion dependence than in the MA setting. In our case as in several others, the disappearance of antidonor HAs and resolution of PRCA were observed after reinforcement of the graft-versus-host effect (i.e. immunosuppression removal or donor leukocytes infusion).