Malfuson J-V, Amor R B, Bonin P, Rodet M, Boccaccio C, Pautas C, Kuentz M, Cordonnier C, Noizat-Pirenne F, Maury S
Department of Hematology, Hôpital Henri Mondor, Université Paris XII, Créteil, France.
Vox Sang. 2007 Jan;92(1):85-9. doi: 10.1111/j.1423-0410.2006.00865.x.
In the setting of major ABO-incompatible allogeneic haematopoietic stem cell transplantation (HSCT), pure red cell aplasia (PRCA) is linked to the persistence of host residual plasma cells secreting antidonor isohaemagglutinins (HA) after transplantation. There are conflicting results regarding the impact of the intensity of conditioning regimen on the occurrence of PRCA after major ABO-mismatched HSCT.
To address this question, we compared two cases occurring after nonmyeloablative (NMA) and myeloablative (MA) HSCT and reviewed previous cases reported in the NMA setting.
We observed a delayed disappearance of antidonor HAs in the NMA setting, associated to a more prolonged period of red blood cells transfusion dependence than in the MA setting. In our case as in several others, the disappearance of antidonor HAs and resolution of PRCA were observed after reinforcement of the graft-versus-host effect (i.e. immunosuppression removal or donor leukocytes infusion).
在主要ABO血型不相合的异基因造血干细胞移植（HSCT）情况下，纯红细胞再生障碍性贫血（PRCA）与移植后宿主残留分泌抗供体同种血凝素（HA）的浆细胞持续存在有关。关于预处理方案强度对主要ABO血型不匹配HSCT后PRCA发生的影响，存在相互矛盾的结果。
为解决这个问题，我们比较了非清髓性（NMA）和清髓性（MA）HSCT后发生的两例病例，并回顾了NMA情况下先前报道的病例。
我们观察到在NMA情况下抗供体HA的消失延迟，与MA情况下相比，红细胞输血依赖期更长。在我们的病例以及其他几个病例中，在增强移植物抗宿主效应（即去除免疫抑制或输注供体白细胞）后，观察到抗供体HA消失和PRCA得到缓解。
