Clinically significant a

Elizabeth A. Jaben, Eapen K. Jacob, Craig Tauscher, Anita D'Souza, William Hogan, James R. Stubbs

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

BACKGROUND: Subgroups of the blood group A (ABO) are generally not considered ABO incompatible for hematopoietic progenitor cell (HPC) transplant. CASE REPORT: A 54-year-old female presented for HPC transplantation for acute leukemia. No HLA-matched donor was identified, so she received a peripheral blood stem cell graft from an HLA-mismatched unrelated donor. On pretransplant testing, both the donor and the recipient typed as blood group A. On Day +67 after transplant, the recipient had a transfusion reaction consisting of an increase in temperature, rigors, and shaking chills during infusion of a unit of group A red blood cells (RBCs). A transfusion reaction workup revealed an ABO discrepancy with both anti-A (1+) and anti-B (3+) identified in the patient's serum as well as a positive direct antiglobulin test with monoclonal anti-IgG antisera. Anti-A1 were identified serologically and in an eluate. Hemolysis was clinically significant, requiring blood transfusion. No ABO typing discrepancies were found on pretransplant testing in either the recipient or the donor. DNA sequencing for blood group A subgroups performed after the transfusion reaction on blood collected before the transplant showed the donor to be type A1 and the recipient as A2. Unfortunately, the patient experienced graft failure requiring reconditioning and reinfusion of additional cells from the original HPC donor. On Day +94 after the second transplant, the patient died with severe acute gastrointestinal graft-versus-host disease. CONCLUSION: This report describes a blood group A2 patient who developed an anti-A1 causing clinically significant hemolysis after HPC transplant from an A1 donor.

Original languageEnglish (US)
Pages (from-to)202-205
Number of pages4
JournalTransfusion
Volume53
Issue number1
DOIs
StatePublished - Jan 2013

Fingerprint

Tissue Donors
Blood Group Antigens
Hematopoietic Stem Cells
Transplants
Hemolysis
varespladib methyl
Coombs Test
Unrelated Donors
Chills
Cell Transplantation
Graft vs Host Disease
DNA Sequence Analysis
Blood Transfusion
Immune Sera
Leukemia
Erythrocytes
Temperature
Serum
Transfusion Reaction

ASJC Scopus subject areas

  • Hematology
  • Immunology
  • Immunology and Allergy

Cite this

Jaben, E. A., Jacob, E. K., Tauscher, C., D'Souza, A., Hogan, W., & Stubbs, J. R. (2013). Clinically significant a. Transfusion, 53(1), 202-205. https://doi.org/10.1111/j.1537-2995.2012.03696.x

Clinically significant a. / Jaben, Elizabeth A.; Jacob, Eapen K.; Tauscher, Craig; D'Souza, Anita; Hogan, William; Stubbs, James R.

In: Transfusion, Vol. 53, No. 1, 01.2013, p. 202-205.

Research output: Contribution to journalArticle

Jaben, EA, Jacob, EK, Tauscher, C, D'Souza, A, Hogan, W & Stubbs, JR 2013, 'Clinically significant a', Transfusion, vol. 53, no. 1, pp. 202-205. https://doi.org/10.1111/j.1537-2995.2012.03696.x
Jaben EA, Jacob EK, Tauscher C, D'Souza A, Hogan W, Stubbs JR. Clinically significant a. Transfusion. 2013 Jan;53(1):202-205. https://doi.org/10.1111/j.1537-2995.2012.03696.x
Jaben, Elizabeth A. ; Jacob, Eapen K. ; Tauscher, Craig ; D'Souza, Anita ; Hogan, William ; Stubbs, James R. / Clinically significant a. In: Transfusion. 2013 ; Vol. 53, No. 1. pp. 202-205.
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