ABO subgroup incompatibility with severe hemolysis after consecutive allogeneic stem cell transplantations

Area of Science:

• Hematology
• Transplantation Immunology

Background:

• Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative option for hematologic malignancies.
• Graft-versus-host disease is a common, severe complication of HSCT.

Observation:

• A patient with relapsed/refractory multiple myeloma underwent consecutive allogeneic HSCTs.
• The patient developed a clinically significant and previously unreported ABO subgroup incompatibility.
• This incompatibility resulted in persistent hemolysis.

Findings:

• The case demonstrates a novel ABO subgroup incompatibility arising post-consecutive HSCT.
• Persistent hemolysis was directly linked to this ABO subgroup mismatch.

Implications:

• Testing for ABO subgroups is crucial during donor selection, particularly after multiple HSCTs.
• Proactive ABO subgroup analysis may prevent severe hemolytic complications in HSCT recipients.
• This finding could refine HSCT protocols for patients with multiple myeloma.