Clinically significant anti-A(1) in a presumed ABO-identical hematopoietic stem cell transplant recipient: a case report

Transfusion
Elizabeth A JabenJames R Stubbs

Abstract

Subgroups of the blood group A (ABO) are generally not considered ABO incompatible for hematopoietic progenitor cell (HPC) transplant. 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-A(1) 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 A(1) and the recipient as A(2) . U...Continue Reading

Citations

Oct 1, 2015·Asian Journal of Transfusion Science·Sabita BasuMammen Chandy
Dec 7, 2018·Transfusion·Willy A Flegel, Stephen M Henry

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