Ito M, Imoto S, Nakagawa T, Kai S, Hara H
Department of Hematology, Hyogo Medical Center for Adults.
Rinsho Ketsueki. 1990 Oct;31(10):1716-20.
Haptoglobin was administered i.v. in 2 cases of ABO incompatible bone marrow transplantation for the prevention of hemoglobinuria due to acute hemolysis. The first case was a 25-year-old woman with severe aplastic anemia. The transplantation was both major and minor mismatch, where the donor was type A and the recipient was type B. The second case was a 31-year-old man with chronic phase of chronic myelogenous leukemia. The transplantation was major mismatch, where the donor was type B and the recipient was type O. After the administrations of haptoglobin 8,000 units we transfused bone marrow infusates from which incompatible erythrocytes were removed. Though prominent hemoglobinemia was observed in both cases, the serum haptoglobin values were not saturated and hemoglobinuria was not detectable. Haptoglobin appears to be useful for the prevention of acute renal failure associated with acute hemolysis in ABO incompatible bone marrow transplantation. Intravenous haptoglobin supplement therapy makes transplantation safer and may contribute to improve the recovery rate of total nucleated bone marrow cells after the erythrocyte depletion without worrying much about their contamination.
在2例ABO血型不相合的骨髓移植中静脉注射触珠蛋白,以预防急性溶血导致的血红蛋白尿。第一例是一名25岁患有严重再生障碍性贫血的女性。移植存在主要和次要错配,供者为A型,受者为B型。第二例是一名31岁处于慢性粒细胞白血病慢性期的男性。移植存在主要错配,供者为B型,受者为O型。在静脉注射8000单位触珠蛋白后,我们输注了去除了不相合红细胞的骨髓输注物。尽管在两例中均观察到明显的血红蛋白血症,但血清触珠蛋白值未饱和,且未检测到血红蛋白尿。触珠蛋白似乎有助于预防ABO血型不相合骨髓移植中与急性溶血相关的急性肾衰竭。静脉补充触珠蛋白疗法可使移植更安全,并且可能有助于提高红细胞去除后全有核骨髓细胞的恢复率,而无需过多担心其污染问题。