Persistent parvovirus B19 infection resulting in red cell aplasia after allogeneic hematopoietic stem cell transplantation

2013 ◽  
Vol 15 (6) ◽  
pp. E239-E242 ◽  
Author(s):  
Y. Koda ◽  
T. Mori ◽  
J. Kato ◽  
S. Kohashi ◽  
T. Kikuchi ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Parvovirus B19 ◽  
Red Cell ◽  
Hematopoietic Stem ◽  
Red Cell Aplasia ◽  
Parvovirus B19 Infection

Delayed donor red cell chimerism and pure red cell aplasia following major ABO-incompatible nonmyeloablative hematopoietic stem cell transplantation

Blood ◽  
2001 ◽  
Vol 98 (6) ◽  
pp. 1687-1694 ◽  
Author(s):  
Charles D. Bolan ◽  
Susan F. Leitman ◽  
Linda M. Griffith ◽  
Robert A. Wesley ◽  
Jo L. Procter ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Pure Red Cell Aplasia ◽  
Consecutive Series ◽  
Red Cell ◽  
Hematopoietic Stem ◽  
Red Cell Aplasia

Abstract Delayed donor red cell engraftment and pure red cell aplasia (PRCA) are well-recognized complications of major ABO-incompatible hematopoietic stem cell transplantation (SCT) performed by means of myeloablative conditioning. To evaluate these events following reduced-intensity nonmyeloablative SCT (NST), consecutive series of patients with major ABO incompatibility undergoing either NST (fludarabine/cyclophosphamide conditioning) or myeloablative SCT (cyclophosphamide/high-dose total body irradiation) were compared. Donor red blood cell (RBC) chimerism (initial detection of donor RBCs in peripheral blood) was markedly delayed following NST versus myeloablative SCT (median, 114 versus 40 days;P < .0001) and strongly correlated with decreasing host antidonor isohemagglutinin levels. Antidonor isohemagglutinins declined to clinically insignificant levels more slowly following NST than myeloablative SCT (median, 83 versus 44 days;P = .03). Donor RBC chimerism was delayed more than 100 days in 9 of 14 (64%) and PRCA occurred in 4 of 14 (29%) patients following NST, while neither event occurred in 12 patients following myeloablative SCT. Conversion to full donor myeloid chimerism following NST occurred significantly sooner in cases with, compared with cases without, PRCA (30 versus 98 days; P = .008). Cyclosporine withdrawal appeared to induce graft-mediated immune effects against recipient isohemagglutinin-producing cells, resulting in decreased antidonor isohemagglutinin levels and resolution of PRCA following NST. These data indicate that significantly delayed donor erythropoiesis is (1) common following major ABO-incompatible NST and (2) associated with prolonged persistence of host antidonor isohemagglutinins. The clinical manifestations of these events are affected by the degree and duration of residual host hematopoiesis.

Pure Red Cell Aplasia following ABO-Mismatched Allogeneic Hematopoietic Stem Cell Transplantation: Resolution with Daratumumab Treatment

2021 ◽  
pp. 1-5
Author(s):  
Israel Henig ◽  
Dana Yehudai-Ofir ◽  
Yaniv Zohar ◽  
Tsila Zuckerman
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Plasma Cells ◽  
Pure Red Cell Aplasia ◽  
Red Cell ◽  
Hematopoietic Stem ◽  
Red Cell Aplasia

Pure red cell aplasia (PRCA) can potentially occur after allogeneic hematopoietic stem cell transplantation (allo-HSCT) if recipient and donor ABO blood groups are mismatched, with the recipient having isoagglutinins against the donor blood group. Patient plasma cells that survive transplant conditioning produce anti-ABO isoagglutinins targeting donor erythroid precursors in the bone marrow and thus causing red cell aplasia. Therapeutic options include steroids, discontinuation of immunosuppression, plasmapheresis, donor lymphocyte infusion, rituximab, and bortezomib, all with limited benefit. Daratumumab utilized in the treatment of multiple myeloma is an anti-CD38 monoclonal antibody targeting plasma cells, which makes it a potentially efficient therapy for PRCA. The current case report presents a patient with post-allo-HSCT PRCA cured with daratumumab applied after failure of other therapies. Our findings demonstrate safety and high efficiency of daratumumab, suggesting its applicability as early treatment of post-allo-HSCT PRCA.

scholarly journals Administration of Daratumumab in the Case of Severe Pure Red Cell Aplasia after Allogeneic Transplantation

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Bicsko RR ◽  
◽  
Magyari F ◽  
Szasz R ◽  
Illes A ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Allogeneic Transplantation ◽  
Pure Red Cell Aplasia ◽  
Red Cell ◽  
Hematopoietic Stem ◽  
Red Cell Aplasia

Pure red cell aplasia is a well-known complication of AB0 major mismatched allogeneic hematopoietic stem cell transplantation. This side effect can be selflimiting, but is occasionally persistent and treated using modalities such as steroids, anti-thymocyte globulin, erythropoietin, donor lymphocyte infusions, rituximab, or plasmapheresis. In some cases, these standard treatments have no effect. We describe a patient with pure red cell aplasia, who received an AB0 major mismatched allogeneic hematopoietic stem cell transplantation. He underwent various treatment for the pure red cell aplasia, but no reticulocytes were present. Daratumumab was started on day 60 and 69 after transplantation, and after two doses of daratumumab, reticulocytosis and the hematocrit increased. Our case clearly represents an additional successful administration of daratumumab, resulting in full recovery of the patient with pure red cell aplasia. Keywords: Allogeneic transplant, pure red cell aplasia, daratumumab, AB0 mismatch

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