scholarly journals Successful treatment of refractory pure red cell aplasia with eltrombopag after ABO-incompatible allogeneic hematopoietic stem cell transplantation

2021 ◽  
Vol 22 (8) ◽  
pp. 695-700
Author(s):  
Yang Gao ◽  
Fei Gao ◽  
Jimin Shi ◽  
Huarui Fu ◽  
He Huang ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Successful Treatment ◽  
Pure Red Cell Aplasia ◽  
Red Cell ◽  
Hematopoietic Stem ◽  
Red Cell Aplasia

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

Prevalence and Trend of Hematopoietic Stem Cell Transplantation for Adult Aplastic Anemia/Pure Red Cell Aplasia in Korea.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3757-3757
Author(s):  
Hawk Kim ◽  
Jin Ho Baek ◽  
Su Jin Shin ◽  
Young Joo Min ◽  
Jae-Hoo Park ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Aplastic Anemia ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Pure Red Cell Aplasia ◽  
Red Cell ◽  
Hematopoietic Stem ◽  
Crude Incidence

Abstract Aplastic anemia (AA) and pure red cell aplasia (PRCA) seems more frequent in Asian countries including Korea. However, there is no exact data regarding its prevalence and frequency of allogeneic hematopoietic stem cell transplantation (HSCT) in Korea. Here we present the demographic data of AA/PRCA in Korea. Data were prepared by retrieving computerized database of National Health Insurance Corporation and Korea National Statistical Office. HSCT data were collected from all HSCT centers in Korea through Korea Hematopoietic Stem Cell Transplantation Nurses’ Society. The selection criteria of PRCA and AA were D60 and D61 in ICD-10 code. Study years for crude incidence/prevalence of AA/PRCA and trend of HSCT for AA/PRCA were from 2000 to 2005, and from 1997 to 2006, respectively. All patients were 10 or more years old. In terms of prevalence, PRCA was decreasing annually from 2000 to 2005 with 0.97, 1.12, 0.72, 0.61, 0.67, and 0.47 per 100,000 persons, respectively. On the contrary, the prevalence of AA was almost same from 2000 to 2005 with 11.28, 12.93, 12.36, 11.07, 11.09, and 10.54 per 100,000 persons, respectively. Female was more affected to both AA and PRCA. The average female to male ratios in AA and PRCA were 1.38 and 1.82. The peak decades of AA were fourth and fifth decades. On the other hand, the peak decades of PRCA were second and sixth decades. The frequency of HSCT for AA/PRCA was increasing in spite of the decreasing crude incidence during a decade from 1997 to 2006, in that 48, 56, 78, 88, 69, 68, 76, 85, 86, and 92, respectively. The frequency of HSCT was similar in both genders. In spite of the possibility of over-estimation, the prevalence of AA and PRCA was very higher in Korea than in western countries.

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