PMID- 36703597
OWN - NLM
STAT- MEDLINE
DCOM- 20230706
LR  - 20230706
IS  - 1098-1101 (Electronic)
IS  - 0733-2459 (Linking)
VI  - 38
IP  - 4
DP  - 2023 Aug
TI  - Successful treatment of pure red cell aplasia using therapeutic plasma exchange 
      after ABO-incompatible hematopoietic stem cell transplant.
PG  - 495-499
LID - 10.1002/jca.22041 [doi]
AB  - Hematopoietic stem cell transplants (HSCTs) are widely used in the treatment of 
      hematologic malignancies and bone marrow failure syndromes. ABO compatibility is 
      typically of secondary importance, and up to 50% of HSCT are performed in 
      ABO-incompatible pairings. In the literature, pure red cell aplasia (PRCA) occurs 
      in 1% to 50% of all major/bidirectional ABO-incompatible stem cell transplants, 
      but treatment of PRCA remains heterogeneous. Here, we report two cases in which 
      patients with transfusion-dependent PRCA following HSCT were successfully treated 
      with therapeutic plasma exchange (TPE). Case 1: A 52-year-old type O-positive 
      male with acute myeloid leukemia underwent HSCT using apheresis-derived HSCs from 
      a fully human leukocyte antigen (HLA)-matched, related type A-positive male 
      donor. He developed PRCA that was refractory to multiple therapies, so a series 
      of 10 TPE was performed over 3 weeks. Case 2: A 21-year-old type A-positive male 
      with aplastic anemia underwent HSCT using bone marrow-derived HSCs from a 
      fully HLA-matched related type B-positive female donor. He developed PRCA that 
      was refractory to multiple therapies, so a series of 5 TPE was performed over 
      2 weeks. Case 1: The patient has been transfusion independent since TPE #7, and 
      type A red blood cells (RBCs) were seen on the ABO type after TPE #9. Case 2: The 
      patient has been transfusion independent since after TPE #1, and type B RBCs were 
      seen on the ABO type after TPE #5. TPE was successful in treating two patients 
      with PRCA after ABO-incompatible HSCT transplants. Isoagglutinin titers decreased 
      below the level of detection for both our patients. Ultimately both patients 
      became transfusion independent and showed evidence of erythroid cell recovery.
CI  - (c) 2023 Wiley Periodicals LLC.
FAU - Vivero, Angelica
AU  - Vivero A
AUID- ORCID: 0000-0002-0251-3593
AD  - Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University 
      Hospital, Philadelphia, Pennsylvania, USA.
FAU - Peedin, Alexis R
AU  - Peedin AR
AUID- ORCID: 0000-0003-3779-8602
AD  - Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University 
      Hospital, Philadelphia, Pennsylvania, USA.
FAU - Gao, Yuanzheng
AU  - Gao Y
AD  - Department of Pathology, Cooper University Health Care, Camden, New Jersey, USA.
FAU - Karp, Julie Katz
AU  - Karp JK
AUID- ORCID: 0000-0002-5970-4585
AD  - Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University 
      Hospital, Philadelphia, Pennsylvania, USA.
LA  - eng
PT  - Case Reports
DEP - 20230126
PL  - United States
TA  - J Clin Apher
JT  - Journal of clinical apheresis
JID - 8216305
RN  - 0 (ABO Blood-Group System)
SB  - IM
MH  - Humans
MH  - Male
MH  - Female
MH  - Middle Aged
MH  - Infant
MH  - *Hematopoietic Stem Cell Transplantation
MH  - Plasma Exchange
MH  - *Red-Cell Aplasia, Pure/therapy
MH  - Erythrocytes
MH  - Transplantation, Homologous
MH  - Blood Group Incompatibility/therapy
MH  - ABO Blood-Group System
OTO - NOTNLM
OT  - ABO-incompatible hematopoietic stem cell transplant
OT  - pure red cell aplasia
OT  - therapeutic plasma exchange
EDAT- 2023/01/28 06:00
MHDA- 2023/07/06 06:42
CRDT- 2023/01/27 02:03
PHST- 2022/12/05 00:00 [revised]
PHST- 2021/09/30 00:00 [received]
PHST- 2023/01/06 00:00 [accepted]
PHST- 2023/07/06 06:42 [medline]
PHST- 2023/01/28 06:00 [pubmed]
PHST- 2023/01/27 02:03 [entrez]
AID - 10.1002/jca.22041 [doi]
PST - ppublish
SO  - J Clin Apher. 2023 Aug;38(4):495-499. doi: 10.1002/jca.22041. Epub 2023 Jan 26.