Rh antibodies against the pretransplant red cells following Rh- incompatible bone marrow transplantation |
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Authors: | MU Heim, M Schleuning, R Eckstein, D Huhn, W Siegert, C Clemm, G Ledderose, HJ Kolb, W Wilmanns, W Mempel |
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Affiliation: | Medizinische Klinik III, Klinikum Grosshadern, University of Munich, Federal Republic of Germany. |
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Abstract: | A 22-year-old, blood group O, Rh-positive (R2r) man received bone marrow from his blood group A, Rh-negative (rr), HLA-identical sister for treatment of acute lymphocytic leukemia. The patient's pretransplantation serum contained anti-A in a low concentration; therefore, plasmapheresis was not done prior to transfusion of bone marrow. To prevent graft-versus-host disease, bone marrow was incubated with absorbed rabbit antithymocyte globulin prior to infusion, and the patient was treated with methotrexate in the posttransplantation period. After transplantation, the patient received 6 units of group O, Rh-negative (rr) packed red cells from random donors and 6 units of platelets from the marrow donor. Three months after transplantation, 0.5 percent of his red cells were still of the host's type (group O, Rh-positive), as detected by immunofluorescence technique in blood smears. Four months after transplantation, three different Rh antibodies--anti-D, -E, and -G--were detected. Since the patient received only Rh-negative red cell transfusions, it is concluded that he was immunized to his original red cells. |
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