A 38-year-old man, blood group A+, was allotransplanted for multiple myeloma from his fully matched sister, blood group O+. Anti-A antibodies IgG and IgM titres of the donor were low. Allogeneic peripheral blood stem cells were harvested by leukapheresis after subcutaneous administration of G-CSF. Rapid engraftment occurred since 5.6 x 10(9)/l leukocytes were achieved on day +9 post-transplant. At this time a severe immune haemolytic syndrome occurred and direct antiglobulin test was positive (IgG and C3d). Elution showed an anti-A specificity. Evolution was rapidly unfavourable related to multiorgan failure. The patient died on day +20 post-transplant.

译文

一名38岁的A血型男子从其完全匹配的姐姐O血型中同种异体移植了多发性骨髓瘤。供体的抗A抗体IgG和IgM滴度较低。皮下给予g-csf后,通过白细胞分离术收集异基因外周血干细胞。由于在移植后第9天实现了5.6 × 10(9)/l白细胞,因此发生了快速植入。此时发生了严重的免疫溶血综合征,直接抗球蛋白试验呈阳性 (IgG和C3d)。洗脱显示出抗A特异性。进化与多器官衰竭迅速不利。患者在移植后第20天死亡。

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