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Pure red cell aplasia after ABO incompatible allogeneic stem cell transplantation treated with therapeutic plasma

Abhijit Baheti1, Brinda Kakkar2, Sameer Melinkeri1

  • 1Department of Clinical Hematology, Deenanath Mangeshkar Hospital and Research Centre, Pune, Maharashtra, India.

Transfusion Medicine (Oxford, England)
|May 28, 2025
PubMed

Pure red cell aplasia (PRCA) is a known complication of major/bi-directional ABO incompatible allogeneic stem cell transplantation (ABOi allo-SCT). Persistence of recipient's antibodies against the donor's red blood cells (RBCs) leads to delay in recovery of RBCs which can last up to several months. This complication can result in patients becoming transfusion dependent. There is no standard treatment but a combination of different treatment strategies which includes tapering immunosuppression/discontinuation, steroid, erythropoietin, anti-CD-20 monoclonal antibody, daratumumab and therapeutic plasma exchange (TPE). Here we report a case of PRCA after ABOi allogeneic peripheral blood SCT treated successfully with TPE.

Keywords:
ABO incompatibleallogeneicpure red cell aplasiastem cell transplantationtherapeutic plasma exchange

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