A Case Analysis of Autoimmune Hemolytic Anemia and Delayed Hemolytic Transfusion Reaction after Umbilical Cord Blood Transplantation

doi:10.3969/j.issn.1671-2587.2025.06.014

JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE ›› 2025, Vol. 27 ›› Issue (6): 835-841.DOI: 10.3969/j.issn.1671-2587.2025.06.014

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A Case Analysis of Autoimmune Hemolytic Anemia and Delayed Hemolytic Transfusion Reaction after Umbilical Cord Blood Transplantation

MA Ting¹, FAN Liangfeng², LI Jingwei³, SUN Yang¹, YANG Jiangcun¹, XIANG Dong²

¹Department of Transfusion Medicine, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi 710068;
²Shanghai Blood Center, Shanghai 200000;
³Department of Transfusion Medicine, Sichuan Provincial People's Hospital, Chengdu, Sichuan 610072

Received:2024-12-11 Published:2025-12-24

Abstract

Abstract: Objective To investigate the rational application of serological techniques in ensuring safe transfusion for a patient with autoimmune hemolytic anemia (AIHA) following umbilical cord blood transplantation in cases of incompatibility crossmatch. Methods A series of tests, including direct antiglobulin test (DAT), antibody identification test, absorption test, acid elution test, antibody titer measurement, and microcolumn agglutination cross-matching test, were performed on the patient's blood samples. Results The patient's blood type was identified as type B and Lu^a antigen was negativity. A Hemolytic crisis occurred after multiple transfusions of red blood cells. IgG-type anti-Ec and anti-Lu^a antibodies were detected in both serum and exudate samples. Tests showed a delayed hemolytic transfusion reaction (DHTR) caused by anti-Ec. Following compatible red blood cells transfusions, the patient's hemoglobin levels showed a significantly improvement, and flow cytometry results indicated a gradual decrease in the proportion of antigen-sensitized cells in the patient's blood. Conclusion DHTR induced by anti-Ec can exacerbate anemia in AIHA patients and may pose a significant risk of hemolysis. The appropriate selection and application of serological techniques can facilitate the identification of clinically significant antibodies, which is crucial for ensuring the transfusion safety.

Key words: Umbilical cord blood transplantation, Anti-Ec, Anti-Lu^a, Delayed hemolytic transfusion reaction Autoimmune hemolytic anemia

CLC Number:

R457.1

MA Ting, FAN Liangfeng, LI Jingwei, SUN Yang, YANG Jiangcun, XIANG Dong. A Case Analysis of Autoimmune Hemolytic Anemia and Delayed Hemolytic Transfusion Reaction after Umbilical Cord Blood Transplantation[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2025, 27(6): 835-841.

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A Case Analysis of Autoimmune Hemolytic Anemia and Delayed Hemolytic Transfusion Reaction after Umbilical Cord Blood Transplantation

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