Allogeneic peripheral blood stem cell transplantation for an acute myeloid leukemia patient with a rare Rh-variant D-- phenotype

We here report a rare case of allogeneic peripheral blood stem cell transplantation (allo-PBSCT) for an acute myeloid leukemia (AML) patient with the Rh-variant D phenotype. People whose red blood cells (RBCs) have a rare deleted Rh phenotype (D ) readily produce anti-Rh17 alloantibodies (an antibody to the RhCc/Ee protein). This causes clinical complications resulting from RBC destruction due to the interaction of alloantibodies with RBCs carrying the corresponding antigen. Consequently, patients with such variants who have formed alloantibodies pose a challenge for transfusions given the scarcity of compatible donors. In fact, in Japan, only 1 in 200,000 individuals are eligible donors. A 26-year-old male AML patient underwent allo-PBSCT from an HLA-matched sibling donor. He had the rare D phenotype and developed anti-Rh17 alloantibodies before allo-PBSCT. Given the scarcity of compatible blood donors for transfusions, the patient required autologous blood donations in preparation for allo-PBSCT. RBC engraftment was prompt during allo-PBSCT; thus, no unscheduled RBC blood transfusion was required. Five months later, his blood type changed to that of his sibling donor, and no irregular antibodies to RBCs were detected. (Journal of Hematopoietic Cell Transplantation 3(3): 93-96, 2014.)