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Persistent Antigen A after Minor ABO-Incompatible Hematopoietic Stem Cell Transplantation in Children: Two Case Reports. | LitMetric
Introduction : ABO blood type changes after ABO-incompatible hematopoietic stem cell transplantation (HSCT). Most non-hematopoietic tissues retain the expression of the patient's own ABO antigens, which may adsorb from the plasma onto the donor's red blood cells (RBCs). Because of this phenomenon, a persistent patient's A and/or B antigen could be detected in the laboratory, despite 100% white cell donor chimerism. Adsorption of the patient's soluble ABO antigens on the newly formed RBCs complicates the interpretation of the patient's blood type and decision of transfusion therapy.Case Presentation : The first case report is a 6-year-old girl, A, D+, with T-cell acute lymphoblastic leukemia (ALL), transplanted with HLA-matched unrelated group O, D+ bone marrow. A second case report describes an 8-year-old girl, AB, D-, with ALL transplanted with an HLA-matched related group B, D+ bone marrow. The presence of persistent antigen A was registered in both patients more than 1 year after HSCT, despite complete donor chimerism.Conclusion : The weak expression of ABO antigens on RBCs after HSCT should be examined in detail for proper planning of transfusion therapies.
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