{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T22:05:57Z","timestamp":1794002757277,"version":"4.8.0"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,11,22]],"date-time":"2018-11-22T00:00:00Z","timestamp":1542844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Hemolysis at the time of graft infusion is one of the immediate complications in major ABO\u2010incompatible allogeneic hematopoietic stem cell transplants (HSCTs). We conducted a retrospective analysis to evaluate the efficacy of donor\u2010type fresh frozen plasma (FFP) in reducing isohemagglutinin titer and preventing hemolysis, as well as its effect on delayed red cell engraftment.<\/jats:p><\/jats:sec><jats:sec><jats:title>MATERIALS AND METHODS<\/jats:title><jats:p>This is a single\u2010center study on a series of 380 allogeneic HSCT between 2005 and 2015; of which 99 were either major (n = 74) or bidirectional (n = 25) ABO mismatched. Pre\u2010transplant infusion of FFP, post\u2010transplant complications and transfusion requirements were determined by retrospective review of individual medical records. Laboratory results were also reviewed for evidence of hemolysis and pure red cell aplasia (PRCA).<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Clinical manifestation of hemolysis attributable to ABO mismatch was present in one recipient of major ABO\u2010incompatible peripheral blood stem cell (PBSC) with a titer of 64. Another recipient of major ABO\u2010incompatible PBSC with a titer of 64 showed biochemical evidence of hemolysis. Both patients recovered with supportive treatment. Hemolysis did not occur in any patients with titer of 32 or less at the time of stem cell infusion. We were unable to demonstrate the influence of any variables on the incidence of PRCA.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>Our experience demonstrated that donor\u2010type FFP is safe and effective in preventing acute hemolysis in major ABO\u2010mismatched HSCT. We have also established the titer of 64 as the threshold that may cause hemolysis and therefore efforts should be made to reduce titer to below this level.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.15053","type":"journal-article","created":{"date-parts":[[2018,11,23]],"date-time":"2018-11-23T09:22:37Z","timestamp":1542964957000},"page":"335-339","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Donor\u2010type fresh frozen plasma is effective in preventing hemolytic reaction in major ABO incompatible allogeneic stem cell transplant"],"prefix":"10.1111","volume":"59","author":[{"given":"Jeffrey","family":"Quek","sequence":"first","affiliation":[{"name":"Department of Hematology Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing Jing","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Hematology Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca Lorraine","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Hematology Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"Diong","sequence":"additional","affiliation":[{"name":"Department of Hematology Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeow Tee","family":"Goh","sequence":"additional","affiliation":[{"name":"Department of Hematology Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sathish","family":"Gopalakrishnan","sequence":"additional","affiliation":[{"name":"Department of Hematology Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aloysius","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Hematology Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Hematology Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mickey","family":"Koh","sequence":"additional","affiliation":[{"name":"Blood Service Group, Health Science Authority  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Loh","sequence":"additional","affiliation":[{"name":"Department of Hematology Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeh Ching","family":"Linn","sequence":"additional","affiliation":[{"name":"Department of Hematology Singapore General Hospital  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