{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:04:02Z","timestamp":1789585442350,"version":"build-2803163510"},"reference-count":15,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,7,13]],"date-time":"2017-07-13T00:00:00Z","timestamp":1499904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Development of de novo alloantibodies against recipient's red blood cell (RBC) antigens by engrafted donor's lymphocytes is a known phenomenon in the setting of allogeneic hematopoietic stem cell transplantation (HSCT). This situation is usually clinically insignificant. We report a case of early clinically relevant hemolytic anemia in a blood group A<jats:sub>1<\/jats:sub> D+ patient, due to a limited production of anti\u2010D and anti\u2010A<jats:sub>1<\/jats:sub> produced by nonpreviously sensitized newly engrafted donor's immune system.<\/jats:p><\/jats:sec><jats:sec><jats:title>CASE REPORT<\/jats:title><jats:p>A 31\u2010year\u2010old Caucasian woman, blood group A<jats:sub>1<\/jats:sub>, D+, with Hodgkin's lymphoma, received an unmanipulated haploidentical allogeneic peripheral blood HSCT after a nonmyeloablative conditioning regimen. Donor blood group was A<jats:sub>2<\/jats:sub>B, D\u2013. The patient had an uneventful course until Day +34, when she developed clinically significant hemolytic anemia with a positive direct antiglobulin test. Anti\u2010D and anti\u2010A<jats:sub>1<\/jats:sub> produced by the donor\u2010engrafted lymphocytes were detected both in serum and in eluate. The hemolysis produced an accelerated group change, turning the patient's ABO group into A<jats:sub>2<\/jats:sub>B 2 weeks after the detection of the alloantibodies. As the residual patient's RBCs progressively disappeared, anti\u2010D and anti\u2010A<jats:sub>1<\/jats:sub> production decreased and were not detected in serum by Day +41.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>This case illustrates that de novo alloantibody production against ABO and D antigens by the newly engrafted donor's lymphocytes can occasionally cause clinically significant anemia. To our knowledge, this is the first case reported of clinically significant hemolytic anemia due to a transient anti\u2010D anti\u2010A<jats:sub>1<\/jats:sub> alloimmunization after T\u2010cell\u2010repleted haploidentical HSCT.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.14232","type":"journal-article","created":{"date-parts":[[2017,7,13]],"date-time":"2017-07-13T14:59:00Z","timestamp":1499957940000},"page":"2355-2358","source":"Crossref","is-referenced-by-count":4,"title":["Transient hemolysis due to anti\u2010D and anti\u2010A<sub>1<\/sub> produced by engrafted donor's lymphocytes after allogeneic unmanipulated haploidentical hematopoietic stem cell transplantation"],"prefix":"10.1111","volume":"57","author":[{"given":"Rebeca","family":"Bail\u00e9n","sequence":"first","affiliation":[{"name":"Hematology and Hemotherapy Department Hospital General Universitario Gregorio 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