López J, Steegmann J L, Pérez G, Otero M J, Berberana M, Cámara R, Lamana M, Fernández Villalta M J, Fernández-Rañada J M
Hermatology Department, Hospital de La Princesa, Madrid, Spain.
Am J Hematol. 1994 Mar;45(3):237-9. doi: 10.1002/ajh.2830450308.
Delayed immune hemolysis can be observed after major ABO-incompatible bone marrow transplants (BMT). The management of these hemolytic episodes includes transfusion of group O red blood cells and increases of immunosuppression. Here we report the case of a 25-year-old patient who developed overt immune hemolysis on day +50 after a HLA-identical ABO-incompatible BMT. To avoid added immunosuppression, erythropoietin was started: an increase in reticulocytes sufficient to maintain hemoglobin despite persistent hemolysis was observed. We conclude that erythropoietin may have a role in the management of delayed-onset hemolysis of major ABO-incompatible BMT, especially when added immunosuppression is undesirable.
在主要ABO血型不合的骨髓移植（BMT）后可观察到延迟性免疫性溶血。这些溶血发作的处理措施包括输注O型红细胞以及增加免疫抑制。在此，我们报告一例25岁患者，其在HLA相合的ABO血型不合BMT后第50天发生明显的免疫性溶血。为避免额外的免疫抑制，开始使用促红细胞生成素：观察到网织红细胞增加，足以在持续溶血的情况下维持血红蛋白水平。我们得出结论，促红细胞生成素可能在主要ABO血型不合BMT延迟性溶血的处理中发挥作用，尤其是在不希望增加免疫抑制的情况下。
