Efficacy of plasmapheresis for the treatment of pure red blood cell aplasia after allogeneic stem cell transplantation.

BACKGROUND: Pure red blood cell aplasia (PRCA) is a complication of ABO major-incompatible stem cell transplantation, likely due to the persistence of memory B lymphocytes of recipient origin, which produce hemagglutinins against ABO antigens on donor RBCs. At present no standard of care is established for this complication. CASE REPORT: We report a case of PRCA after allogeneic bone marrow transplantation, successfully treated with plasma exchange (PEX) after failing erythropoietin administration. RESULTS: The patient fully recovered from RBC aplasia. CONCLUSION: This case suggests a role for PEX in the treatment of PRCA after allogeneic stem cell transplantation.