ERYTHROPOIETIN IN THE TREATMENT OF DELAYED IMMUNE HEMOLYSIS OF A MAJOR ABO-INCOMPATIBLE BONE-MARROW TRANSPLANT

Delayed immune hemolysis can be observed after major ABO-incompatible bone marrow transplants (BMT). The management of these hemolytic episodes includes transfusion of group O red blood cells and increases of immunosuppression. Here we report the case of a as-year-old patient who developed overt immune hemolysis on day +50 after a HLA-identical ABO-incompatible BMT. To avoid added immunosuppression, erythropoietin was started: an increase in reticulocytes sufficient to maintain hemoglobin despite persistent hemolysis was observed. We conclude that erythropoietin may have a role in the management of delayed-onset hemolysis of major ABO-incompatible BMT, especially when added immunosuppression is undesirable. (C) 1994 Wiley-Liss, Inc.