Post-transplant pediatric autoimmune hemolytic anemia: donor vs donor or recipient vs self? Post-transplant pediatric AIHA

Alessandra Bernardi; Pierpaolo Berti; Elisabetta Cicchetti; Fabiola Landi; Ottavia Porzio

doi:10.2450/BloodTransfus.905

Letter to the Editor

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Post-transplant pediatric autoimmune hemolytic anemia: donor vs donor or recipient vs self?

Alessandra Bernardi , Pierpaolo Berti , Elisabetta Cicchetti , Fabiola Landi , Ottavia Porzio

Key words: autoimmune hemolytic anemia, pediatrics, Hematopoietic Stem Cell Transplantation, immunohematology

DOI: 10.2450/BloodTransfus.905

Immunohematology

Publication Date: 2024-11-29

Abstract

Hematopoietic stem cell transplantation (HSCT) is a potentially curative treatment for various blood disorders. However, post-transplant complications such as autoimmune hemolytic anemia (AIHA) can arise, especially in pediatric patients. We present a case of a 7-year-old male with beta-thalassemia major who developed AIHA nine months post-HSCT from an unrelated donor. Despite initial successful treatment with cyclosporine and prednisone, the patient experienced multiple relapses, coinciding with changes in donor-recipient chimerism. This case highlights the complexity of post-transplant immune dysregulation and suggests a recipient-driven autoimmune mechanism.

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Alessandra Bernardi - Transfusion Medicine Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy

Pierpaolo Berti - Transfusion Medicine Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy https://orcid.org/0000-0003-0512-2704

Elisabetta Cicchetti - Transfusion Medicine Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy

Fabiola Landi - Transfusion Medicine Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy

Ottavia Porzio - Transfusion Medicine Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy; Clinical Biochemistry Laboratory, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy; Department of Experimental Medicine, Tor Vergata University, Rome, Italy

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