Successful treatment of severe immune hemolytic anemia after allogeneic stem cell transplantation with bortezomib: report of a case and review of literature. Issue 2 (25th August 2014)

• Record Type: Journal Article
• Authors: Hosoba, Sakura; Jaye, David L.; Cohen, Cynthia; Roback, John D.; Waller, Edmund K.
• Is Part Of: Transfusion. Volume 55:Issue 2(2015)
• Page Start: 259
• Page End: 264
• Publication Date: 2014-08-25
• Subjects: Hematology -- Periodicals; Blood -- Transfusion -- Periodicals; Blood Group Antigens -- Periodicals; Blood Preservation -- Periodicals; Blood Transfusion -- Periodicals; 615
• DOI: 10.1111/trf.12815
• Languages: English
• ISSNs: 0041-1132

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="trf12815-sec-0001" sec-type="section"> <title>Background</title> <p>Immune hemolytic anemia is a well‐known complication after allogeneic hematopoietic stem cell transplantation (HSCT). Posttransplant hemolytic anemia results in increased red blood cell transfusions and medical sequelae including iron overload.</p> </sec> <sec id="trf12815-sec-0002" sec-type="section"> <title>Case Report</title> <p>We present a case report of immune hemolytic anemia that occurred after allogeneic HSCT from an ABO major–mismatched, HLA‐matched unrelated donor. The patient had high anti‐donor A type antibodies that were unresponsive to treatment with steroids and rituximab, resulting in persistent transfusion dependence. A detailed time course of anti‐A titers, plasma cell content of the marrow, and B‐cell content of the blood is presented. Treatment with bortezomib, a protease inhibitor, eliminated residual host‐type plasma cells secreting anti‐A and restored normal donor‐derived erythropoiesis.</p> </sec> <sec id="trf12815-sec-0003" sec-type="section"> <title>Conclusion</title> <p>This report, and a review of literature for treatment of immune hemolytic anemia after allogeneic HSCT, supports the utility of bortezomib as plasma cell–targeted therapy in this setting.</p> </sec> </abstract>