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Donor‐type fresh frozen plasma is effective in preventing hemolytic reaction in major ABO incompatible allogeneic stem cell transplant
- Source :
- Transfusion. 59:335-339
- Publication Year :
- 2018
- Publisher :
- Wiley, 2018.
-
Abstract
- Background Hemolysis at the time of graft infusion is one of the immediate complications in major ABO-incompatible allogeneic hematopoietic stem cell transplants (HSCTs). We conducted a retrospective analysis to evaluate the efficacy of donor-type fresh frozen plasma (FFP) in reducing isohemagglutinin titer and preventing hemolysis, as well as its effect on delayed red cell engraftment. Materials and methods This is a single-center study on a series of 380 allogeneic HSCT between 2005 and 2015; of which 99 were either major (n = 74) or bidirectional (n = 25) ABO mismatched. Pre-transplant infusion of FFP, post-transplant complications and transfusion requirements were determined by retrospective review of individual medical records. Laboratory results were also reviewed for evidence of hemolysis and pure red cell aplasia (PRCA). Results Clinical manifestation of hemolysis attributable to ABO mismatch was present in one recipient of major ABO-incompatible peripheral blood stem cell (PBSC) with a titer of 64. Another recipient of major ABO-incompatible PBSC with a titer of 64 showed biochemical evidence of hemolysis. Both patients recovered with supportive treatment. Hemolysis did not occur in any patients with titer of 32 or less at the time of stem cell infusion. We were unable to demonstrate the influence of any variables on the incidence of PRCA. Conclusion Our experience demonstrated that donor-type FFP is safe and effective in preventing acute hemolysis in major ABO-mismatched HSCT. We have also established the titer of 64 as the threshold that may cause hemolysis and therefore efforts should be made to reduce titer to below this level.
- Subjects :
- Adult
Male
Immunology
Pure red cell aplasia
030204 cardiovascular system & hematology
Hemolysis
Isohemagglutinin
ABO Blood-Group System
Plasma
03 medical and health sciences
0302 clinical medicine
ABO blood group system
medicine
Humans
Immunology and Allergy
Retrospective Studies
Peripheral Blood Stem Cell Transplantation
business.industry
Hematopoietic Stem Cell Transplantation
Hematopoietic stem cell
Hematology
Middle Aged
medicine.disease
Titer
medicine.anatomical_structure
Blood Group Incompatibility
Peripheral Blood Stem Cells
Female
Fresh frozen plasma
Stem cell
business
030215 immunology
Subjects
Details
- ISSN :
- 15372995 and 00411132
- Volume :
- 59
- Database :
- OpenAIRE
- Journal :
- Transfusion
- Accession number :
- edsair.doi.dedup.....95d13ec0b95a52a42da9db5dc8e37487