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.

  • Letter to the Editor
  • Published:

Post-transplant induction of donor-type anti-RhD antibodies production shortly followed by complete hemolysis of recipient-type erythrocytes in RhD-mismatched allogeneic bone marrow recipient

Bone Marrow Transplantation volume 37, pages 433–434 (2006)Cite this article

Pre-existing anti-RhD-alloantibodies in allogeneic bone marrow donors are relatively seldom observed and may lead to hemolytic post transplant complications in RhD-mismatched recipients. We describe an HLA-matched sibling bone marrow transplant with RhD-mismatch and presence of pre-formed anti-RhD-alloantibodies in the donor. The recipient was a 58-year-old RhD-positive female with AML M2 FAB morphology, 46XX, FLT3(+), diagnosed 9 months before, in CR1 achieved after two induction chemotherapy courses, then followed by two consolidation chemotherapy courses and maintenance therapy. The donor was her HLA-matched 57-year-old RhD-negative sister who had been pregnant in the past and who tested anti-RhD-antibody positive in titer 1 (and anti-RhC-antibody in titer 32). ABO was compatible in donor and recipient.

Myeloablative conditioning consisted of Treosulfan 14 g/m2/day on days from −6 to −4, Fludarabine 30 mg/m2/day on days from −6 to −2. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine-A 3 mg/kg/day and methotrexate 15 mg/m2 on day +1 and 10 mg/m2 on days +3, +6 and +11. Transplanted bone marrow after centrifugation and removal of anti-RhD-antibodies positive plasma contained 3.0 × 108 NC/kg, 3.0 × 106 CD34+ cells/kg and 35.0 × 106 CD3+ cells/kg.

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

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

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

References

  1. Erker CG, Steins MB, Fischer RJ, Kienast J, Berdel WE, Sibrowski W et al. The influence of blood group differences in allogeneic hematopoietic peripheral blood progenitor cell transplantation. Transfusion 2005; 45: 1382–1390.

    Article  Google Scholar 

  2. Fung MK, Sheikh H, Eghtesad B, Lopez-Plaza I . Severe hemolysis resulting from D incompatibility in a case of ABO-identical liver transplant. Transfusion 2004; 44: 1635–1639.

    Article  Google Scholar 

  3. Samsel M, Debski R, Sedzimirska M . Pregnancy after ABO and Rh mismatched allotransplantation of peripheral blood progenitor cells, complicated by Rh disease. Ginekol-Pol 2005; 76: 308–312.

    PubMed  Google Scholar 

  4. Mijovic A . Alloimmunization to RhD antigen in RhD-incompatible haemopoietic cell transplants with non-myeloablative conditioning. Vox-Sang 2002; 83: 358–362.

    Article  Google Scholar 

  5. Gandini G, Franchini M, de Gironcoli M, Vassanelli A, Benedetti F, Turrini A et al. Detection of an anti-RhD antibody 2 years after sensitization in a patient who had undergone an allogeneic BMT. Bone Marrow Transplant 2000; 25: 457–459.

    Article  CAS  Google Scholar 

  6. Kim BK, Whitsett CF, Hillyer CD . Donor origin Rh antibodies as a cause of significant hemolysis following ABO-identical orthotopic liver transplantation. Immunohematology 1992; 8: 100–101.

    CAS  PubMed  Google Scholar 

  7. Aguilera V, Arriaga F, de-la-Rubia J, Prieto M, Sanchez J . Hemolytic anemia due to ABO or Rh antibodies in recipients of solid organ transplants. Med Clin (Barc) 2003; 120: 177–179.

    Article  Google Scholar 

  8. Frohn C, Jabs WJ, Fricke L, Goerg S . Hemolytic anemia after kidney transplantation: case report and differential diagnosis. Ann Hematol 2002; 81: 158–160.

    Article  CAS  Google Scholar 

  9. Sokol RJ, Stamps R, Booker DJ, Scott FM, Laidlaw ST, Vandenberghe EA et al. Posttransplant immune-mediated hemolysis. Transfusion 2002; 42: 198–204.

    Article  Google Scholar 

  10. Izumi N, Fuse I, Furukawa T, Uesugi Y, Tsuchiyama J, Toba K et al. Long-term production of pre-existing alloantibodies to E and c after allogenic BMT in a patient with aplastic anemia resulting in delayed hemolytic anemia. Transfusion 2003; 43: 241–245.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Hematology and Bone Marrow Transplantation, Silesian Medical Academy, Katowice, Poland

    M Markiewicz, J Wojnar, S Giebel, I Wyleżoł & J Hołowiecki

  2. Beskidzkie Centrum Onkologii, Bielsko-Biała, Poland

    A Wieczorkiewicz

Authors
  1. M Markiewicz
    View author publications

    Search author on:PubMed Google Scholar

  2. J Wojnar
    View author publications

    Search author on:PubMed Google Scholar

  3. S Giebel
    View author publications

    Search author on:PubMed Google Scholar

  4. A Wieczorkiewicz
    View author publications

    Search author on:PubMed Google Scholar

  5. I Wyleżoł
    View author publications

    Search author on:PubMed Google Scholar

  6. J Hołowiecki
    View author publications

    Search author on:PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Markiewicz, M., Wojnar, J., Giebel, S. et al. Post-transplant induction of donor-type anti-RhD antibodies production shortly followed by complete hemolysis of recipient-type erythrocytes in RhD-mismatched allogeneic bone marrow recipient. Bone Marrow Transplant 37, 433–434 (2006). https://doi.org/10.1038/sj.bmt.1705254

Download citation

  • Published:

  • Issue date:

  • DOI: https://doi.org/10.1038/sj.bmt.1705254

Search

Advanced search

Quick links