Haematologica
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Haematologica, Vol 92, Issue 12, e132-e135 doi:10.3324/haematol.12074
Copyright © 2007 by Ferrata Storti Foundation
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Rituximab for prevention of delayed hemolytic transfusion reaction in sickle cell disease

F. Noizat-Pirenne1,2,, D. Bachir3, P. Chadebech1, M. Michel2,4, A. Plonquet5, J.-C. Lecron6, F. Galactéros2, P. Bierling1,2

1 Etablissement Français du Sang, Ile de France, Hôpital Henri Mondor, Créteil;
2 Centre de Référence des Cytopénies Auto-Immunes, Hôpital Henri Mondor, Créteil;
3 Service des Maladies Génétiques du Globule Rouge, Hôpital Henri Mondor Créteil;
4 Service de Médecine Interne, Hôpital Henri Mondor, Créteil;
5 Laboratoire d’Immunologie, Hôpital Henri Mondor, Créteil;
6 Université de Poitiers, EA 3806, CHU de Poitiers

Correspondence: France Noizat-Pirenne, MD, PhD, Etablissement Français du Sang d’Ile de France, 51 Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France. Tel: 331 56 72 76 37; Fax: 331 56 72 76 01, E-mail: france.noizat-pirenne{at}efs.sante.fr

Delayed hemolytic transfusion reaction (DHTR), a life-threatening transfusion complication in sickle cell disease (SCD), is characterized by a marked hemoglobin drop with destruction of both transfused and autologous red blood cells (RBCs) and exacerbation of SCD symptoms. One mechanism of RBCs destruction is auto-antibody production secondary to transfusion. As rituximab specifically targets circulating B cells, we thought that it could be beneficial in preventing this immune-mediated transfusion complication. We report the case of a SCD patient who previously experienced DHTR with auto-antibodies and who needed a new transfusion. DHTR recurrence was successfully prevented by rituximab administration prior transfusion, supporting the safe use of rituximab to prevent DHTR in SCD patients as a second line approach when other measures failed.

Key words: Sickle cell disease, rituximab, transfusion, auto-antibodies.






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Copyright © 2007 by the Ferrata Storti Foundation.