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The exact transformation process and cell lines involved are not well\u2010understood. A patient with PMF received an allogenic hematopoietic stem cell transplant (alloHCT) from his major ABO incompatible sibling and developed pure red cell aplasia that resolved when his blood type switched to that of his donor\u2019s. He relapsed with AML 10\u2009months after alloHCT; interestingly, his blood type remained his donor\u2019s type. 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