Pure red cell aplasia following ABO-incompatible allogeneic hematopoietic stem cell transplantation

The objectives of study was to investigate the clinical characteristics and risk factors of pure red cell aplasia (PRCA) following ABO-incompatible allogeneic hematopoietic stem cell transplantation (allo-HSCT). The clinical data of 72 patients receiving ABO-incompatible allo-HSCT were collected and retrospectively studied. The clinical parameters including sex, age, granulocyte engraftment time and blood transfusion were analyzed for the exploration of risk factors resulting in development of PRCA. The results indicated that 4 out of 72 patients receiving ABO-incompatible allogeneic hematopoietic stem cell transplantation developed PRCA, 3 cases out of these patients were ABO-major incompatible, 1 case was Bi-direction incompatible, nor any effect of PRCA was observed on incidence of GVHD and CMV infection. In conclusion, PRCA is a major complication of patients receiving ABO-incompatible allo-HSCT, while ABO blood group of O/A in recipient/donor pair may be the major high risk factor for PRCA after ABO-mismatched allo-HSCT.