Pure red cell aplasia after major ABO-incompatible bone marrow transplantation: two case reports of treatment with recombinant human erythropoietin

Transpl Int. 1996;9(5):506-8. doi: 10.1007/BF00336830.

Abstract

A 34-year-old man with acute myelocytic leukemia (AML: MO) and a 32-year-old woman with AML: M2 developed pure red cell aplasia (PRCA) after receiving a major ABO incompatible bone marrow transplant (BMT). The first patient responded to recombinant human erythropoietin (rhEPO) therapy, while the second did not. The second patient also received methylprednisolone (m-PSL) but developed reticulocytosis and hemolysis after the administration of m-PSL. Plasmapheresis was then performed and the patient promptly recovered from hemolysis and PRCA. We conclude that close attention must be paid when treating PRCA following major ABO-incompatible BMT with rhEPO and m-PSL, as there is always the potential for massive hemolysis.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • ABO Blood-Group System / immunology*
  • Acute Disease
  • Adult
  • Blood Group Incompatibility / etiology*
  • Blood Group Incompatibility / immunology
  • Bone Marrow Transplantation / adverse effects*
  • Erythropoietin / therapeutic use*
  • Female
  • Humans
  • Leukemia, Myeloid / complications
  • Leukemia, Myeloid / therapy*
  • Leukemia, Myeloid, Acute / complications
  • Leukemia, Myeloid, Acute / therapy*
  • Male
  • Models, Immunological
  • Recombinant Proteins
  • Red-Cell Aplasia, Pure / drug therapy
  • Red-Cell Aplasia, Pure / etiology*
  • Red-Cell Aplasia, Pure / immunology
  • Remission Induction
  • Transplantation, Homologous / adverse effects*

Substances

  • ABO Blood-Group System
  • Recombinant Proteins
  • Erythropoietin