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Nephrol Dial Transplant (2003) 18: 2405-2408
© 2003 European Renal Association-European Dialysis and Transplant Association

Brief Report

Removal of persisting isohaemagglutinins with Ig-Therasorb® immunoadsorption after major ABO-incompatible non-myeloablative allogeneic haematopoietic stem cell transplantation

Werner Rabitsch1, Paul Knöbl2, Hildegard Greinix1, Erika Prinz1, Peter Kalhs1, Walter H. Hörl3 and Kurt Derfler3

1Department of Medicine I, Bone Marrow Transplantation Unit, 2Department of Haematology and Haemostaseology and 3Department of Medicine III, Division of Nephrology and Dialysis, University of Vienna, Vienna, Austria

Correspondence and offprint requests to: Dr Werner Rabitsch, Department of Medicine 1, Bone Marrow Transplantation Unit, Währinger Gürtel 18-20, A-1090 Vienna, Austria. Email: werner.rabitsch{at}akh-wien.ac.at

Background. Major ABO-incompatibility can be associated with haemolysis, prolonged red cell aplasia (PRCA) and higher peri-transplant mortality resulting from organ toxicity after conventional and non-myeloablative allogeneic haematopoietic stem cell transplantation. Different therapeutic strategies have been developed to allow erythroid reconstitution in these patients.

Methods. We present three patients, who developed PRCA after non-myeloablative allogeneic haematological stem cell transplantation for haematological malignancies. The patients were treated with Ig-Therasorb® immunoadsorption (five treatments per week) to remove persisting incompatible isohaemagglutinins.

Results. Two patients became transfusion independent after 12 and 14 treatments. In one patient, however, no reduction of the isohaemagglutinin titres could be observed after 25 treatments, probably due to persistence of his underlying disease.

Conclusions. Although Ig-Therasorb® immunoadsorption was effective in only two patients, it seems to be a promising therapeutic option for patients with PRCA after allogeneic non-myeloablative haematological stem cell transplantation.

Keywords: blood component removal; blood group incompatibility; haematopoetic stem cell transplantation; red cell aplasia


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