ABO-incompatible bone marrow transplantation: Three methods for the removal of red blood cell antibodies

Abstract

We analyzed three different methods for removing red blood cell (RBC) antibodies in 28 patients before a major ABO-incompatible bone marrow transplantation (BMT). Six patients were treated with extensive plasma exchange. Antibody titers were lowered from 1:512 to 1:4 (median values). In ten patients antibodies were removed by extracorporeal immunoadsorption using an adsorbent column. Titers decreased from 1:128 to 1:32. In four of these ten patients plasma exchange was added to complete antibody removal. Twelve patients were treated with simple in vivo adsorption with donor-type RBCs before marrow infusion. In eight of them, titers became undetectable. Advantages and disadvantages of the three methods are discussed.