caa a22 4500 463255720 CHVBK 20180405153354.0 cr unu---uuuuu 170326e20070901xx s 000 0 eng 10.1007/s00277-007-0304-8 doi (NATIONALLICENCE)springer-10.1007/s00277-007-0304-8 Pure red-cell aplasia following major and bi-directional ABO-incompatible allogeneic stem-cell transplantation: recovery of donor-derived erythropoiesis after long-term treatment using different therapeutic strategies [Elektronische Daten] [Grzegorz Helbig, Beata Stella-Holowiecka, Jerzy Wojnar, Malgorzata Krawczyk, Slawomira Krzemien, Maria Wojciechowska-Sadus, Mirosław Markiewicz, Iwona Wylezol, Malgorzata Kopera, Jerzy Holowiecki] Blood group incompatibility between donor and recipient of allogeneic stem cell transplants may be associated with post-transplant erythroid aplasia. A total of 548 patients (pts) received allogeneic transplant for malignant and non-malignant hematologic disorders. In a retrospective analysis, the prevalence and outcome of pure red-cell aplasia (PRCA) in 44 pts with major and bi-directional ABO-mismatch were investigated. Bone marrow grafts were major ABO incompatible in 30 pts; there was bi-directional mismatch in the remaining 14 pts. The median number of transplanted mononuclear cells (NC) was 4.74 × 108/kg (range 0.1-26.4) including CD34+ cells, 3.02 × 106/kg (range 0.9-21.7). Granulocyte engraftment >0.5 × 10e9/l occurred after a median of 21days (7-32), and platelet exceeded >50 × 10e9/l after a median of 23.5days (12-109). Acute and chronic graft vs host disease (GVHD) developed in 23 (52%) and 26 (59%) of the patients, respectively. Six (13%) patients transplanted with major and bi-directional ABO-incompatibility developed PRCA. The treatment of PRCA consisted of plasmapheresis (PEX), rapid cyclosporine (CsA) discontinuation, donor lymphocyte infusions (DLI), erythropoietin (EPO), azathioprine, and rituximab. The therapy resulted in erythroid recovery in five out of six patients after a median of 13months (range 3-16). The median number of transfused red blood cells (RBCs) was 36U (range 8-57). With a median follow-up of 37months, the 5-year probability of overall survival (OS) for the PRCA group was 66%. Major ABO mismatch may lead to delayed donor erythroid engraftment. It results in long-term transfusion dependence and, therefore, the risk of iron overload. The therapy is long lasting, but usually effective in majority of patients. Springer-Verlag, 2007 Pure red-cell aplasia nationallicence Allogeneic hematopoietic stem cell transplantation nationallicence ABO blood group incompatibility nationallicence Treatment nationallicence Helbig Grzegorz Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Reymont Street 8, 40-027, Katowice, Poland aut Stella-Holowiecka Beata Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Reymont Street 8, 40-027, Katowice, Poland aut Wojnar Jerzy Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Reymont Street 8, 40-027, Katowice, Poland aut Krawczyk Malgorzata Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Reymont Street 8, 40-027, Katowice, Poland aut Krzemien Slawomira Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Reymont Street 8, 40-027, Katowice, Poland aut Wojciechowska-Sadus Maria Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Reymont Street 8, 40-027, Katowice, Poland aut Markiewicz Mirosław Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Reymont Street 8, 40-027, Katowice, Poland aut Wylezol Iwona Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Reymont Street 8, 40-027, Katowice, Poland aut Kopera Malgorzata Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Reymont Street 8, 40-027, Katowice, Poland aut Holowiecki Jerzy Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Reymont Street 8, 40-027, Katowice, Poland aut Annals of Hematology Springer-Verlag 86/9(2007-09-01), 677-683 0939-5555 86:9<677 2007 86 277 https://doi.org/10.1007/s00277-007-0304-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00277-007-0304-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Helbig Grzegorz Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Reymont Street 8, 40-027, Katowice, Poland aut NATIONALLICENCE 700 1- Stella-Holowiecka Beata Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Reymont Street 8, 40-027, Katowice, Poland aut NATIONALLICENCE 700 1- Wojnar Jerzy Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Reymont Street 8, 40-027, Katowice, Poland aut NATIONALLICENCE 700 1- Krawczyk Malgorzata Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Reymont Street 8, 40-027, Katowice, Poland aut NATIONALLICENCE 700 1- Krzemien Slawomira Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Reymont Street 8, 40-027, Katowice, Poland aut NATIONALLICENCE 700 1- Wojciechowska-Sadus Maria Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Reymont Street 8, 40-027, Katowice, Poland aut NATIONALLICENCE 700 1- Markiewicz Mirosław Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Reymont Street 8, 40-027, Katowice, Poland aut NATIONALLICENCE 700 1- Wylezol Iwona Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Reymont Street 8, 40-027, Katowice, Poland aut NATIONALLICENCE 700 1- Kopera Malgorzata Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Reymont Street 8, 40-027, Katowice, Poland aut NATIONALLICENCE 700 1- Holowiecki Jerzy Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Reymont Street 8, 40-027, Katowice, Poland aut NATIONALLICENCE 773 0- Annals of Hematology Springer-Verlag 86/9(2007-09-01), 677-683 0939-5555 86:9<677 2007 86 277 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer