CT-513 Pure Red Cell Aplasia in Major ABO-Incompatible Allogenic Stem Cell Transplantation: Retrospective Analysis From a Single-Center Experience

• Published in: Clinical lymphoma, myeloma and leukemia myeloma and leukemia, 2023-09, Vol.23, p.S532-S532
• Main Authors: Alonso, David, Cabrero, Mónica, Fonseca, Marta, Alejo, Elena, Navarro, José María, Gómez, Sandra Patricia, Puerta, Carlos, Zapata, Evelyn, García, Pablo, Fuentes, Cristina Teresa, Fernández, Adolfo, Clavo, Diego, Santos, Carmen, Malaver, Rafael José, Martín, Ana África, Lopez, Miriam, Martín-Mateos, Maria Luisa, Pérez-López, Estefanía, Puertas, Borja, Hernadez, Alberto, Baile, Mónica, Cabero, Almudena, Avendaño, Alejandro, de Ramon, Cristina, García-Bacelar, Ana, Vázquez, Lourdes, Sánchez-Guijo, Fermin, López-Villar, Olga, López-Corral, Lucía
• Format: Article
• Language: English
• Subjects: allogeneic HSCT; cellular therapy; major ABO incompatibility; pure red cell aplasia
• ISSN: 2152-2650; 2152-2669
• DOI: 10.1016/S2152-2650(23)01519-7

Pure red cell aplasia (PRCA) is a complication of major ABO incompatibility (ABO-MM) allogeneic stem cell transplantation (alloHSCT). Evidence is lacking for PRCA incidence, optimal management, and prognosis. To describe the characteristics of PCRA in a homogeneous patient sample. Retrospective review of patients receiving alloHSCT in our center between 2017 and 2021, selected for those with suspected PCRA. Inclusion criteria: anemia (hemoglobin [Hb] 1500/μL; >50 000/μL); bone marrow (BM) erythroid progenitor aplasia or hypoplasia (1 line of therapy. All but 3 patients (76.9%) achieved complete response (Hb >10 g/dL without transfusion) after a median of 62 days (range, 6–119 days). One patient did not respond after 3 lines of therapy and is still under treatment; 2 patients died before resolution of PCRA from relapsed acute myeloid leukemia (n=1) and acute graft-vs-host disease (n=1). Our results are in line with previously published studies. Moreover, we demonstrate that PRCA can be underdiagnosed. Our most used treatment was erythropoietin; the majority of patients achieved a satisfactory response. Given the low incidence of this complication, multicenter studies are needed to better characterize PRCA.