RESUMO
In 3 of 15 consecutive patients receiving a human leukocyte antigen (HLA)-identical but major ABO incompatible bone marrow transplant (BMT), pure red cell aplasia (PRA) lasting 5 to 8 months was observed. Titers of the incompatible anti-A agglutinin before infusion of the red blood cell (RBC)-depleted BMT was very high in one, and in the usual range in two patients. Decrease of agglutinin titers during the first 4 weeks after BMT were comparable between PRA patients and those of ABO-incompatible BMT recipients with timely RBC recovery. However, in PRA patients, agglutinin titers rose again and remained elevated for 19 to 28 weeks. RBC engraftment and reticulocyte recovery ultimately occurred spontaneously and coincided with the decrease of agglutinin titers below 16. These observations indicate that PRA is antibody-dependent in this setting. Furthermore, it is conceivable that cyclosporine facilitates recipient-derived antibody synthesis after major ABO-incompatible BMT.
Assuntos
Incompatibilidade de Grupos Sanguíneos/complicações , Transplante de Medula Óssea , Eritropoese , Sistema ABO de Grupos Sanguíneos , Doença Enxerto-Hospedeiro/prevenção & controle , Humanos , Isoanticorpos/análise , Fatores de TempoRESUMO
A total of 30 leukaphereses were performed with the Aminco Cellseparator on 27 healthy donots. Pretreatment by steroids and addition of fluid gelatin to the input line was performed in all runs. The combination of continuous flow centrifugation and filtration leukapheresis (CFC-FL) in nine of the 30 runs resulted in a highly significant increase of the yield to a mean of 59.6 X 1o(9) granulocytes as compared with a mean of 30.8 X 10(9) granulocytes obtained with conventional CFC. This significance is valid for the total yield of granulocytes, the yield per hour of run, or per liter of blood processed. No adverse reaction occurred.
