Unusual Occurrence of Six Anti-erythrocyte Alloantibodies in an Rh(D)-negative Man with Myelodysplastic Syndrome

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We report an Rh(D)-negative man with myelodysplastic syndrome who produced six anti-erythrocyte alloantibodies (anti-D, -C, -E, -Di^a, -Jk^a and -S) in succession. Three of these antibodies (anti-E, -Jk^a and -S) were not noted until delayed hemolytic transfusion reactions occurred. Treatment with cortico-steroids was effective in preventing both further formations of antibodies and other transfusion reactions. It was very difficult to find blood compatible with the patient, but repetitive blood transfusions were required for his progressive anemia and thrombocytopenia. Several problems concerning the transfusion of blood in such a case are discussed.