A Case of Pure Red Cell Aplasia Following ABO-Incompatible Bone Marrow Transplantation.
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A 13-year-old ABO-O Rh D positive girl with ALL received a bone marrow transplant from her HLA genotypically identical, but ABO-A Rh D positive, brother. Short-term methotrexate and cyclosporine were administered for prophylaxis of graft-versus-host disease. Engraftment of myeloid and megakaryocytic lineages was normal, but erythroid engraftment was merely postulated. Anemia did not improve even with the administration of prednisolone. On day 87 bone marrow aspirate revealed that erythroid precursors were markedly decreased, hemoglobin was decreased to 5.3 g/dl, and reticulocyte was 3‰. On day 95, methyl-prednisolone (m-PSL) was administered intravenously at a dose of 20 mg/kg. The next day, her liver function was worse and m-PSL was discontinued. On day 124 reticulocyte was 94‰, on day 138, hemoglobin was increased to 11.8 g/ dl. On day 87 her anti-A agglutinin titer was 1 : 128, and on day 138 it decreased to 1 : 1. These observations suggest that anti-A agglutinin correlated with a risk factor for the development of pure red cell aplasia (PRCA). In conclusion, in consideration of the possibilities of PRCA after major ABO-incompatible allogeneic BMT, a study is needed to determine an appropriate treatment for PRCA.
- 特定非営利活動法人 日本小児血液・がん学会の論文
特定非営利活動法人 日本小児血液・がん学会 | 論文
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