Transient anti rhesus alloantibody produced by graft after non-myeloablative allogeneic stem cell transplant

Background: We report the case of a patient who received an allogeneic transplant with peripheral blood compatible ABO, Rhesus mismatched progenitor cells and who developed an asymptomatic transient anti Rhesus alloimmunisation. Case report: A 56-year-old man with renal cell carcinoma received a non...

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Bibliographic Details
Published in:Transfusion and apheresis science 2004-12, Vol.31 (3), p.191-197
Main Authors: Contentin, N., Lenain, P., Chamouni, P., Hau, F., Bastit, D., Buchonnet, G., Tilly, H.
Format: Article
Language:English
Subjects:
Allogeneic peripheral blood stem cell
Alloimmunisation
Carcinoma, Renal Cell - therapy
Erythrocyte Transfusion
Health technology assessment
Humans
Isoantibodies - blood
Kidney Neoplasms - therapy
Male
Middle Aged
Non-myeloablative stem cell transplant
Renal cell carcinoma
Rh-Hr Blood-Group System - immunology
Rhesus blood system
Stem Cell Transplantation
Transplantation, Homologous
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Summary:Background: We report the case of a patient who received an allogeneic transplant with peripheral blood compatible ABO, Rhesus mismatched progenitor cells and who developed an asymptomatic transient anti Rhesus alloimmunisation. Case report: A 56-year-old man with renal cell carcinoma received a non-myeloablative allogeneic PBPC ABO compatible graft from his HLA-identical brother. Graft-versus-host disease prophylaxis consisted of cyclosporine alone. On day + 59, prior to any transfusion, a positive direct antiglobulin test (IgG++, C3d−) was detected. The indirect antiglobulin test (IAT) was considered doubtful, and IAT identification revealed the presence of an active anti Rhesus antibody (anti D specificity) in the patient’s serum. This immunisation had no clinical consequence, with no acute hemolytic episode. Further monitoring showed negative antibody screening tests on day + 78. Conclusion: To our knowledge this is the first reported case of transient anti Rh (D) allo-immunisation after non-myeloablative allogeneic peripheral blood progenitor cell (PBPC) transplant. The period of occurrence and the specificity of this antibody strongly suggest a donor cell origin.
ISSN:1473-0502
1878-1683
DOI:10.1016/j.transci.2004.01.013