A CASE OF DELAYED ERYTHROPOIESIS AFTER BONE MARROW TRANSPLANTATION FROM AN ABO-COMPATIBLE SIBLING DONOR FOR ACQUIRED CHRONIC PURE RED CELL APLASIA

DOI Web Site 9 References
  • Nishida Tetsuya
    Department of Hematology and Oncology, Nagoya University Graduate School of Medicine
  • Imahashi Mayumi
    Department of Hematology and Oncology, Nagoya University Graduate School of Medicine
  • Imahashi Nobuhiko
    Department of Hematology and Oncology, Nagoya University Graduate School of Medicine
  • Ohashi Haruhiko
    Clinical Research Center, National Hospital Organization Nagoya Medical Center
  • Katsumi Akira
    Department of Hematology and Oncology, Nagoya University Graduate School of Medicine
  • Terakura Seitaro
    Department of Hematology and Oncology, Nagoya University Graduate School of Medicine
  • Murata Makoto
    Department of Hematology and Oncology, Nagoya University Graduate School of Medicine
  • Kiyoi Hitoshi
    Department of Hematology and Oncology, Nagoya University Graduate School of Medicine
  • Naoe Tomoki
    Department of Hematology and Oncology, Nagoya University Graduate School of Medicine

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Other Title
  • 後天性慢性赤芽球癆に対するABO血液型一致同胞間骨髄移植後も赤血球造血のみ遅延した1例

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<p>Acquired chronic pure red cell aplasia (PRCA) is primarily caused by an autoimmune mechanism. Although immunosuppressive therapies are generally effective for the treatment of chronic PRCA, treatment for patients with immunosuppressant-refractory or recurrent PRCA is sometimes difficult. A 36-year-old female was diagnosed with PRCA complicated by diffuse systemic sclerosis, and underwent HLA-identical and ABO-compatible bone marrow transplantation for PRCA refractory to cyclosporine. Both neutrophil and platelet levels recovered soon after transplantation. However, donor erythropoiesis was delayed, and red blood cell transfusions were required more than 2 months after transplantation. Since mixed donor chimerism (50-60%) persisted in the T-cell lineage, 1.10×107/kg and 3.30×107/kg of donor CD3+ T cells were infused on days 64 and 85, respectively. Afterwards, the recovery of erythropoiesis was observed together with conversion to complete donor chimerism in the T-cell lineage. Allogeneic bone marrow transplantation is effective for refractory PRCA and complete donor chimerism is crucial for curing PRCA.</p>

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