Transfusion management of an IgA deficient patient with anti‐IgA and incidental correction of IgA deficiency after allogeneic bone marrow transplantation

• Published in: American journal of hematology 1998-04, Vol.57 (4), p.326-330
• Main Authors: Rogers, R.L., Javed, T.A., Ross, R.E., Virella, G., Stuart, R.K., Frei‐Lahr, D.
• Format: Article
• Language: English
• Subjects: Adult; anaphylactic reaction; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antibodies, Anti-Idiotypic - metabolism; anti‐IgA; Biological and medical sciences; Blood Transfusion; bone marrow transplantation; Bone Marrow Transplantation - immunology; Bone marrow, stem cells transplantation. Graft versus host reaction; Humans; IgA deficiency; IgA Deficiency - therapy; Immunoglobulin A - immunology; Male; Medical sciences; Multiple Myeloma - therapy; Transfusions. Complications. Transfusion reactions. Cell and gene therapy
• ISSN: 0361-8609; 1096-8652
• DOI: 10.1002/(SICI)1096-8652(199804)57:4<326::AID-AJH10>3.0.CO;2-6

A patient with multiple myeloma was noted to have an IgA deficiency during investigation of a possible transfusion reaction due to IgA deficiency and anti‐IgA. Because of the patient's age, otherwise good health, and early stage of disease, he was enrolled in a research treatment protocol that involved an allogeneic bone marrow transplant (BMT). The BMT successfully put the patient in complete remission from his multiple myeloma and corrected his IgA deficiency. Class‐specific IgG anti‐IgA antibody that had been identified prior to BMT was no longer detectable in his plasma. Anaphylactic transfusion reactions were successfully avoided by using a combination of IgA‐deficient and washed blood components including the marrow graft, and IgA‐reduced intravenous immunoglobulin. Am. J. Hematol. 57:326–330, 1998. © 1998 Wiley‐Liss, Inc.