ABO Incompatible Bone Marrow Transplantation for Children

Abstract

Eight children with severe aplastic anemia or acute leukemia underwent bone marrow transplantation (BMT) from major ABO incompatible donors. Removal of red blood cells from donor marrow was performed by hydroxyethyl starch (HES) sedimentation following processing with HM30 (HV50) blood cell separator. Marrow infusion caused no adverse effect except transient mild hemoglobinuria in one patient. No remarkable hemolysis was noted during the erythroid recovery stage. Durable engraftment was obtained in all children, but marked delay of erythroid recovery was observed in one patient who had had a high titer of pre-transplant anti-red blood cell antibody. The other three children with minor ABO incompatibility underwent BMT after removal of plasma from donor marrow by centrifugation. Marrow infusion was achieved safely and no hemolytic episode occurred.