| Objective: To study the incidence, risk factors, clinical outcome, management and prevention of pure red cell aplasia ( PRCA ) following major ABO- incompatible allogeneic hematopoietic stem cell transplantation ( allo-HSCT ). Method: We retrospectively analyzed 11 cases of PRCA from a series of 42 patients undergoing major ABO-incompatible allo-HSCT from April, 1997 to December, 2005. The six clinical parameters were selected for univariate analysis: recipient blood group,donor blood group,donor/recipient blood group,donor type, transplant type and aGVHD to identify risk factors for the development of PRCA. Factors that were significant at the 0.1 level on univariate analysis were evaluated by multivariate analysis using a logistic regression. The study is also involved in the management and prevention of PRCA following allo-HSCT.Results: 1,11 out of the 42 patients developed PRCA ( 26.1 % ); 2, All the 11 cases of PRCA were in blood group O recipients of grafts from blood group A donor (n=9) or blood group B donor (n=2). 3,The following factors were associated with an increased risk of PRCA by univariate analysis: (1) blood group O recipient ( P=0.004 ) ; (2) blood group A donor ( P=0.036 ); (3) blood group O/A in recipient/donor pair ( P=0.002 ); 4, These risk factors were entered into a multivariate model. Only blood group O/A in recipient/donor pair was identified as being significantly associated with the occurrence of PRCA ( P=0.006 ); 5,Six patients who received donor-type plasma exchange didn't develop PRCA. 8 patients with PRCA obtained spontaneous remission. In the remaining 3 patients, 2 patients with long-lasting PRCA were successfully treated with plasma exchange with donor-type plasma replacement , and the other one who was also complicated by EBV-associated lymphoproliferative disorder ( EBV-PTLD ) responded rapidly to Retuximab ( anti-CD20 monoclonal antibody ) and achieved complete resolution of...
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