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Pure red cell aplasia after major or bidirectional ABO incompatible hematopoietic stem cell transplantation: to treat or not to treat, that is the question

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Abstract

Pure red cell aplasia (PRCA) is a complication related to major or bidirectional ABO mismatched hematopoietic stem cell transplantation. This disorder is characterized by anemia, reticulocytopenia, and the absence or virtual absence of erythroid progenitors, other causes such as infections, hemolysis, disease relapse, or drug toxicity having been excluded. Patients with PRCA may become RBC transfusion dependent for long periods, suffering an important long-term iron overload, alloimmunization, and transfusion reactions. The persistence of recipient isoagglutinins against donor ABO antigens produced by host residual plasmatic cells has been considered as the immunological cause of the prolonged erythroid aplasia. PRCA behaves in many cases as a self-limited condition and resolution may occur spontaneously within weeks, months, and even years. Many different therapeutic approaches have been reported for posttransplant PRCA as plasmapheresis, high doses of erythropoietin, donor lymphocyte infusions, anti-thymocyte globulin, Rituximab and steroids, among others. However, to date there is no standard of care and the question if patients with PRCA should be treated and at which point remains. The objective of this article is to review the natural evolution of PRCA, and the treatments that have been used over time focusing on their suitability and efficacy.

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References

  1. Yamamoto F. Review: ABO blood group system-ABH oligosaccharide antigens, anti-A and anti-B, A and B glycosyltransferases, and ABO genes. Immunohematology. 2004;20:3–22.

    CAS  PubMed  Google Scholar 

  2. Booth GS, Gehrie EA, Bolan CD, Savani BN. Clinical guide to ABO-incompatible allogeneic stem cell transplantation. Biol Blood Marrow Transplant. 2013;19:1152–8.

    CAS  PubMed  Google Scholar 

  3. Rowley SD, Donato ML, Bhattacharyya P. Red blood cell-incompatible allogeneic hematopoietic progenitor cell transplantation. Bone Marrow Transplant. 2011;46:1167–85.

    CAS  PubMed  Google Scholar 

  4. Blin N, Traineau R, Houssin S, de Latour RP, Petropoulou A, Robin M, et al. Impact of donor-recipient major ABO mismatch on allogeneic transplantation outcome according to stem cell source. Biol Blood Marrow Transplant. 2010;16:1315–23.

    PubMed  Google Scholar 

  5. Damodar S, Shanley R, MacMillan M, Ustun C, Weisdorf D. Donor-to-recipient ABO mismatch does not impact outcomes of allogeneic hematopoietic cell transplantation regardless of graft source. Biol Blood Marrow Transplant. 2017;23:795–804.

    PubMed  PubMed Central  Google Scholar 

  6. Worel N, Kalhs P, Keil F, Prinz E, Moser K, Schulenburg A, et al. ABO mismatch increases transplant-related morbidity and mortality in patients given nonmyeloablative allogeneic HPC transplantation. Transfusion. 2003;43:1153–61.

    PubMed  Google Scholar 

  7. Petz LD. Immunohematologic problems associated with bone marrow transplantation. Transfus Med Rev. 1987;1:85–100.

    CAS  PubMed  Google Scholar 

  8. Gmür JP, Burger J, Schaffner A, Neftel K, Oelz O, Frey D, et al. Pure red cell aplasia of long duration complicating major ABO-incompatible bone marrow transplantation. Blood. 1990;75:290–5.

    PubMed  Google Scholar 

  9. Bolan CD, Leitman SF, Griffith LM, Wesley RA, Procter JL, Stroncek DF, et al. Delayed donor red cell chimerism and pure red cell aplasia following major ABO-incompatible nonmyeloablative hematopoietic stem cell transplantation. Blood. 2001;98:1687–94.

    CAS  PubMed  Google Scholar 

  10. Aneke JC, Sondi N, Thyagu S, Cserti-Gazdewich CM, Pendergrast J. Donor-specific isoagglutinin clearance in ABO mismatched stem cell transplant recipients: how long should it normally take?. Blood. 2018;132 Suppl 1:1260–0.

  11. Lee J-H, Lee J-H, Choi S-J, Kim S, Seol M, Kwon S-W, et al. Changes of isoagglutinin titres after ABO-incompatible allogeneic stem cell transplantation. Br J Haematol. 2003;120:702–10.

    CAS  PubMed  Google Scholar 

  12. Griffith LM, McCoy JPJ, Bolan CD, Stroncek DF, Pickett AC, Linton GF, et al. Persistence of recipient plasma cells and anti-donor isohaemagglutinins in patients with delayed donor erythropoiesis after major ABO incompatible non-myeloablative haematopoietic cell transplantation. Br J Haematol. 2005;128:668–75.

    CAS  PubMed  Google Scholar 

  13. Sahovic EA, Flick J, Graham CD, Stuart RK. Case report: isoimmune inhibition of erythropoiesis following ABO-incompatible bone marrow transplantation. Am J Med Sci. 1991;302:369–73.

    CAS  PubMed  Google Scholar 

  14. Helbig G, Stella-Holowiecka B, Wojnar J, Krawczyk M, Krzemien S, Wojciechowska-Sadus M, et al. Pure red-cell aplasia following major and bi-directional ABO-incompatible allogeneic stem-cell transplantation: recovery of donor-derived erythropoiesis after long-term treatment using different therapeutic strategies. Ann Hematol. 2007;86:677–83.

    PubMed  Google Scholar 

  15. Lee J-H, Lee K-H, Kim S, Lee J-S, Kim SH, Kwon S-W, et al. Anti-A isoagglutinin as a risk factor for the development of pure red cell aplasia after major ABO-incompatible allogeneic bone marrow transplantation. Bone Marrow Transplant. 2000;25:179–84.

    CAS  PubMed  Google Scholar 

  16. Mielcarek M, Leisenring W, Torok-Storb B, Storb R. Graft-versus-host disease and donor-directed hemagglutinin titers after ABO-mismatched related and unrelated marrow allografts: evidence for a graft-versus-plasma cell effect. Blood. 2000;96:1150–6.

    CAS  PubMed  Google Scholar 

  17. Zhu K-E, Li J-P, Zhang T, Zhong J, Chen J. Clinical features and risk factors of pure red cell aplasia following major ABO-incompatible allogeneic hematopoietic stem cell transplantation. Hematology. 2007;12:117–21.

    PubMed  Google Scholar 

  18. Aung FM, Lichtiger B, Bassett R, Liu P, Alousi A, Bashier Q, et al. Incidence and natural history of pure red cell aplasia in major ABO-mismatched haematopoietic cell transplantation. Br J Haematol. 2013;160:798–805.

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Mehta P, Ramprakash S, Raghuram C, Trivedi D, Marwah P, Soni R, et al. In-vivo adsorption of iso-haemagglutinin (IHA) antibodies by donor type red cell transfusion during conditioning is a safe and effective method to overcome major ABO incompatibility-related acute hemolytic reactions in stem cell transplant using bone marrow as stem cell graft source. Blood. 2019;134:4467–7.

    Google Scholar 

  20. Stussi G, Halter J, Bucheli E, Valli PV, Seebach L, Gmür J, et al. Prevention of pure red cell aplasia after major or bidirectional ABO blood group incompatible hematopoietic stem cell transplantation by pretransplant reduction of host anti-donor isoagglutinins. Haematologica. 2009;94:239–48.

    PubMed  PubMed Central  Google Scholar 

  21. Heyll A, Aul C, Runde V, Arning M, Schneider W, Wernet P. Treatment of pure red cell aplasia after major ABO-incompatible bone marrow transplantation with recombinant erythropoietin. Blood. 1991;77:906.

    CAS  PubMed  Google Scholar 

  22. Tsai H-J, Lin S-F, Liu T-C, Chang C-S, Hsiao H-H, Chen T-P. Pure red cell aplasia after ABO major-mismatched allogeneic peripheral blood stem cell transplantation successfully treated with plasma exchange and low-dose steroid: two case reports. Kaohsiung J Med Sci. 2004;20:128–32.

    PubMed  Google Scholar 

  23. Labar B, Bogdanić V, Nemet D, Kovacević-Metelko J, Mrsić M, Pavletić Z, et al. Antilymphocyte globulin for treatment of pure red cell aplasia after major ABO incompatible marrow transplant. Bone Marrow Transplant. 1992;10:471–2.

    CAS  PubMed  Google Scholar 

  24. Sorà F, De Matteis S, Piccirillo N, Chiusolo P, Laurenti L, Putzulu R, et al. Rituximab for pure red cell aplasia after ABO-mismatched allogeneic peripheral blood progenitor cell transplantation. Transfusion. 2005;45:643–5.

    PubMed  Google Scholar 

  25. Hirokawa M, Fukuda T, Ohashi K, Hidaka M, Ichinohe T, Iwato K, et al. Efficacy and long-term outcome of treatment for pure red cell aplasia after allogeneic stem cell transplantation from major ABO-incompatible donors. Biol Blood Marrow Transplant. 2013;19:1026–32.

    PubMed  Google Scholar 

  26. Tomac G, Bojanic I, Mazic S, Vidovic I, Raos M, Cepullic BG, et al. Haemolysis, pure red cell aplasia and red cell antibody formation associated with major and bidirectional ABO incompatible haematopoietic stem cell transplantation. Blood Transfus. 2018;16:397–404.

    PubMed  PubMed Central  Google Scholar 

  27. Busca A, Dellacasa C, Giaccone L, Manetta S, Biale L, Godio L, et al. Eltrombopag for the treatment of refractory pure RBC aplasia after major ABO incompatible hematopoietic stem cell transplantation. Biol Blood Marrow Transplant. 2018;24:1765–70.

    CAS  PubMed  Google Scholar 

  28. Aung FM, Lichtiger B, Rondon G, Yin CC, Alousi A, Ahmed S, et al. Pure red cell aplasia in major ABO-mismatched allogeneic hematopoietic stem cell transplantation is associated with severe pancytopenia. Biol Blood Marrow Transplant. 2016;22:961–5.

    PubMed  PubMed Central  Google Scholar 

  29. Atilla E, Topcuoglu P, Akkus E, Ataca Atilla P, Civriz Bozdag S, Kurt Yuksel M, et al. Impact of ABO mismatch on outcomes of allogeneic hematopoietic stem cell recipients: 30 years of experience with 1016 patients. Blood. 2018;132 Suppl 1:3472–2.

  30. Maciej Zaucha J, Mielcarek M, Takatu A, Little M-T, Gooley T, Baker J, et al. Engraftment of early erythroid progenitors is not delayed after non-myeloablative major ABO-incompatible haematopoietic stem cell transplantation. Br J Haematol. 2002;119:740–50.

    CAS  PubMed  Google Scholar 

  31. Sniecinski IJ, Oien L, Petz LD, Blume KG. Immunohematologic consequences of major ABO-mismatched bone marrow transplantation. Transplantation. 1988;45:530–4.

    CAS  PubMed  Google Scholar 

  32. Paltiel O, Cournoyer D, Rybka W. Pure red cell aplasia following ABO-incompatible bone marrow transplantation: response to erythropoietin. Transfusion. 1993;33:418–21.

    CAS  PubMed  Google Scholar 

  33. Ohashi K, Akiyama H, Takamoto S, Tanikawa S, Sakamaki H, Onozawa Y. Treatment of pure red cell aplasia after major ABO-incompatible bone marrow transplantation resistant to erythropoietin. Bone marrow transplantation team. Bone Marrow Transplant. 1994;13:335–6.

    CAS  PubMed  Google Scholar 

  34. Santamaría A, Sureda A, Martino R, Domingo-Albós A, Muñiz-Díaz E, Brunet S. Successful treatment of pure red cell aplasia after major ABO-incompatible T cell-depleted bone marrow transplantation with erythropoietin. Bone Marrow Transplant. 1997;20:1105–7.

    PubMed  Google Scholar 

  35. Bavaro P, Di Girolamo G, Olioso P, Papalinetti G, Iacone A, Accorsi P, et al. Donor lymphocyte infusion as therapy for pure red cell aplasia following bone marrow transplantation. Br J Haematol. 1999;104:930–1.

    CAS  PubMed  Google Scholar 

  36. Yamaguchi M, Sakai K, Murata R, Ueda M. Treatment of pure red cell aplasia after major ABO-incompatible peripheral blood stem cell transplantation by induction of chronic graft-versus-host disease. Bone Marrow Transplant. 2002;30:539–41.

    CAS  PubMed  Google Scholar 

  37. Badros A, Tricot G, Toor A, Morris C, Guo C, Munshi N, et al. ABO mismatch may affect engraftment in multiple myeloma patients receiving nonmyeloablative conditioning. Transfusion. 2002;42:205–9.

    PubMed  Google Scholar 

  38. Zhu K-E, Xu Y, Wu D, Zhong J. Pure red cell aplasia following major ABO-incompatible allogeneic hematopoietic stem cell transplantation. Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2002;10:61–5.

    PubMed  Google Scholar 

  39. Zhidong W, Hongmin Y, Hengxiang W. Successful treatment of pure red cell aplasia with a single low dose of rituximab in two patients after major ABO incompatible peripheral blood allogeneic stem cell transplantation. Transfus Med. 2012;22:302–4.

    CAS  PubMed  Google Scholar 

  40. Ohta S, Yokoyama H, Ise T, Takasawa K, Wada T, Nakao S, et al. Apheresis therapy for prolonged red cell aplasia after major ABO-mismatched bone marrow transplantation. Intern Med. 1997;36:487–91.

    CAS  PubMed  Google Scholar 

  41. Worel N, Greinix HT, Schneider B, Kurz M, Rabitsch W, Knöbl P, et al. Regeneration of erythropoiesis after related- and unrelated-donor BMT or peripheral blood HPC transplantation: a major ABO mismatch means problems. Transfusion. 2000;40:543–50.

    CAS  PubMed  Google Scholar 

  42. Nussbaumer W, Schwaighofer H, Gratwohl A, Kilga S, Schonitzer D, Nachbaur D, et al. Transfusion of donor-type red cells as a single preparative treatment for bone marrow transplants with major ABO incompatibility. Transfusion. 1995;35:592–5.

    CAS  PubMed  Google Scholar 

  43. Or R, Naparstek E, Mani N, Slavin S. Treatment of pure red-cell aplasia following major ABO-mismatched T-cell-depleted bone marrow transplantation. Two case reports with successful response to plasmapheresis. Transpl Int. 1991;4:99–102.

    CAS  PubMed  Google Scholar 

  44. Ustün C, Celebi H, Arat M, Ozcan M, Dilek I, Gürman G, et al. Treatment of aregeneratoric anemia following an ABO-incompatible allogeneic peripheral blood stem cell transplantation: a case report. Ther Apher. 1999;3:275–7.

    PubMed  Google Scholar 

  45. Dellacasa CM, D’Ardia S, Allione B, Aydin S, Tassi V, Francisci T, et al. Efficacy of plasmapheresis for the treatment of pure red blood cell aplasia after allogeneic stem cell transplantation. Transfusion. 2015;55:2979–82.

    CAS  PubMed  Google Scholar 

  46. Sackett K, Cohn CS, Fahey-Ahrndt K, Smith AR, Johnson AD. Successful treatment of pure red cell aplasia because of ABO major mismatched stem cell transplant. J Clin Apher. 2018;33:108–12.

    PubMed  Google Scholar 

  47. Rabitsch W, Knöbl P, Greinix H, Prinz E, Kalhs P, Hörl WH, et al. Removal of persisting isohaemagglutinins with Ig-Therasorb immunoadsorption after major ABO-incompatible non-myeloablative allogeneic haematopoietic stem cell transplantation. Nephrol Dial Transplant. 2003;18:2405–8.

    PubMed  Google Scholar 

  48. Verholen F, Stalder M, Helg C, Chalandon Y. Resistant pure red cell aplasia after allogeneic stem cell transplantation with major ABO mismatch treated by escalating dose donor leukocyte infusion. Eur J Haematol. 2004;73:441–6.

    CAS  PubMed  Google Scholar 

  49. Zhu K, Chen J, Chen S. Treatment of Epstein-Barr virus-associated lymphoproliferative disorder (EBV-PTLD) and pure red cell aplasia (PRCA) with Rituximab following unrelated cord blood transplantation: a case report and literature review. Hematology. 2005;10:365–70.

    CAS  PubMed  Google Scholar 

  50. Fang B, Song Y, Li N, Li J, Han Q, Zhao RC. Mesenchymal stem cells for the treatment of refractory pure red cell aplasia after major ABO-incompatible hematopoietic stem cell transplantation. Ann Hematol. 2009;88:261–6.

    PubMed  Google Scholar 

  51. Roychowdhury DF, Linker CA. Pure red cell aplasia complicating an ABO-compatible allogeneic bone marrow transplantation, treated successfully with antithymocyte globulin. Bone Marrow Transplant. 1995;16:471–2.

    CAS  PubMed  Google Scholar 

  52. Furuya H, Wakayama T, Tanaka J, Tsumori M, Hatazoe T, Ohguni S, et al. Treatment with bolus methylprednisolone for pure red cell aplasia after ABO incompatible bone marrow transplantation in a patient with chronic myelocytic leukemia. Rinsho Ketsueki. 1995;36:1279–83.

    CAS  PubMed  Google Scholar 

  53. Yang M-H, Hsu H-C. Pure red cell aplasia after ABO-incompatible allogeneic stem cell transplantation in severe aplastic anemia with response to steroids: a case report and literature review. Ann Hematol. 2001;80:299–301.

    CAS  PubMed  Google Scholar 

  54. Deotare UR, Vishwabandya A, Mathews V, George B, Srivastava A, Chandy M. Response to high-dose dexamethasone for acquired pure red cell aplasia following ABO-mismatched allogeneic stem cell transplantation. Bone Marrow Transplant. 2006;37:1149–50.

    CAS  PubMed  Google Scholar 

  55. Yang X, Levis M. Pulsed-high-dose dexamethasone as a treatment for pure red cell aplasia following ABO-incompatible allogeneic stem cell transplantation. Transfus Med. 2014;24:246–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  56. Hiroshima Y, Shiono Y, Suzuki I, Yamamoto M, Kato Y, Tajima K, et al. Successful high-dose dexamethasone treatment of acquired pure red cell aplasia following ABO major mismatched allogeneic hematopoietic stem cell transplantation. Rinsho Ketsueki. 2016;57:760–4.

    PubMed  Google Scholar 

  57. Varela Gómez R, Vázquez Vázquez G, Noriega Concepción V, Galego García A, Andón Saavedra C. Successful treatment of pure red cell aplasia with high-dose dexamethasone after ABO-incompatible allogeneic hematopoietic stem cell transplantation. Hematol Oncol Stem Cell Ther. 2018;11:44–6.

    PubMed  Google Scholar 

  58. Maschan AA, Skorobogatova EV, Balashov DN, Pashanov ED, Trakhtman PE, Schipitzina IP, et al. Successful treatment of pure red cell aplasia with a single dose of rituximab in a child after major ABO incompatible peripheral blood allogeneic stem cell transplantation for acquired aplastic anemia. Bone Marrow Transplant. 2002;30:405–7.

    CAS  PubMed  Google Scholar 

  59. Al-Okk H, Diaz B, Stives S, Parumog N, Conway M, Nath R. Successful resolution of pure red cell aplasia (PRCA) following major ABO incompatible unrelated donor stem cell transplantation using rituximab. Blood. 2003;102:437B–8B.

    Google Scholar 

  60. Helbig G, Stella-Holowiecka B, Krawczyk-Kulis M, Wojnar J, Markiewicz M, Wojciechowska-Sadus M, et al. Successful treatment of pure red cell aplasia with repeated, low doses of rituximab in two patients after ABO-incompatible allogeneic haematopoietic stem cell transplantation for acute myeloid leukaemia. Haematologica. 2005;90:ECR33.

    PubMed  Google Scholar 

  61. Woo H-Y, Min C-K, Lee S-M, Cho H-S, Kim S-Y, Lee S, et al. Resistant pure red cell aplasia after allogeneic bone marrow transplantation with major ABO mismatch treated by purified CD34+ cell infusion. Eur J Haematol. 2006;76:160–3.

    PubMed  Google Scholar 

  62. Bierman PJ, Warkentin P, Hutchins MR, Klassen LW. Pure red cell aplasia following ABO mismatched marrow transplantation for chronic lymphocytic leukemia: response to antithymocyte globulin. Leuk Lymphoma. 1993;9:169–71.

    CAS  PubMed  Google Scholar 

  63. Ebihara Y, Manabe A, Tsuruta T, Ishikawa K, Hasegawa D, Ohtsuka Y, et al. The effect of donor leukocyte infusion on refractory pure red blood cell aplasia after allogeneic stem cell transplantation in a patient with myelodysplastic syndrome developing from Kostmann syndrome. Int J Hematol. 2007;86:446–50.

    PubMed  Google Scholar 

  64. Selleri C, Raiola A, De Rosa G, Luciano L, Pezzullo L, Picardi M, et al. CD34+-enriched donor lymphocyte infusions in a case of pure red cell aplasia and late graft failure after major ABO-incompatible bone marrow transplantation. Bone Marrow Transplant. 1998;22:605–7.

    CAS  PubMed  Google Scholar 

  65. Corcione A, Benvenuto F, Ferretti E, Giunti D, Cappiello V, Cazzanti F, et al. Human mesenchymal stem cells modulate B-cell functions. Blood. 2006;107:367–72.

    CAS  PubMed  Google Scholar 

  66. Fang B, Song Y, Zhao RC, Han Q, Cao Y. Treatment of resistant pure red cell aplasia after major ABO-incompatible bone marrow transplantation with human adipose tissue-derived mesenchymal stem cells. Am J Hematol. 2007;82:772–3.

    PubMed  Google Scholar 

  67. Robak P, Robak T. Bortezomib for the treatment of hematologic malignancies: 15 years later. Drugs R D. 2019;19:73–92.

    CAS  PubMed  PubMed Central  Google Scholar 

  68. Poon L-M, Koh LP. Successful treatment of isohemagglutinin-mediated pure red cell aplasia after ABO-mismatched allogeneic hematopoietic cell transplant using bortezomib. Bone Marrow Transplant. 2012;47:870–1.

    CAS  PubMed  Google Scholar 

  69. Khan F, Linden MA, Zantek ND, Vercellotti GM. Subcutaneous bortezomib is highly effective for pure red cell aplasia after ABO-incompatible haematopoietic stem cell transplantation. Transfus Med. 2014;24:187–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  70. Shahan JL, Hildebrandt GC. Successful treatment of refractory pure red cell aplasia with bortezomib after allogeneic haematopoietic cell transplantation in a patient with alpha-beta subcutaneous panniculitis-like T cell lymphoma. Transfus Med. 2015;25:342–4.

    CAS  PubMed  Google Scholar 

  71. Bathini S, Holtzman NG, Koka R, Singh Z, Wilding E, Zou Y, et al. Refractory postallogeneic stem cell transplant pure red cell aplasia in remission after treatment with daratumumab. Am J Hematol. 2019;94:E216–9.

    PubMed  Google Scholar 

  72. Salas MQ, Alahmari A, Lipton JH. Successful treatment of refractory red cell aplasia after allogeneic hematopoietic cell transplantation with daratumumab. Eur J Haematol. 2020;104:145–7.

    CAS  PubMed  Google Scholar 

  73. Desmond R, Townsley DM, Dunbar C, Young NS. Eltrombopag in aplastic anemia. Semin Hematol. 2015;52:31–7.

    CAS  PubMed  Google Scholar 

  74. Nishida H, Yamada T. Monoclonal antibody therapies in multiple myeloma: a challenge to develop novel targets. J Oncol. 2019;2019:6084012.

    PubMed  PubMed Central  Google Scholar 

  75. Chapuy CI, Kaufman RM, Alyea EP, Connors JM. Daratumumab for delayed red-cell engraftment after allogeneic transplantation. N Engl J Med. 2018;379:1846–50.

    CAS  PubMed  Google Scholar 

  76. Rautenberg C, Kaivers J, Germing U, Haas R, Ackerstaff S, Hoffmann T, et al. Daratumumab for treatment of pure red cell aplasia after allogeneic stem cell transplantation. Bone Marrow Transplant. 2020;55:1191–3.

    PubMed  Google Scholar 

  77. Jeyaraman P, Borah P, Rajput P, Dayal N, Pathak S, Naithani R. Daratumumab for pure red cell aplasia post ABO incompatible allogeneic hematopoietic stem cell transplant for aplastic anemia. Blood Cells Mol Dis. 2020;102464.

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  1. Hospital Universitario y Politécnico La Fe, Valencia, Spain

    Javier Marco-Ayala, Inés Gómez-Seguí, Guillermo Sanz & Pilar Solves

  2. Centro de Investigación Biomédica en Red de Cáncer, CIBERONC, Instituto de Salud Carlos III, Madrid, Spain

    Inés Gómez-Seguí, Guillermo Sanz & Pilar Solves

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Marco-Ayala, J., Gómez-Seguí, I., Sanz, G. et al. Pure red cell aplasia after major or bidirectional ABO incompatible hematopoietic stem cell transplantation: to treat or not to treat, that is the question. Bone Marrow Transplant 56, 769–778 (2021). https://doi.org/10.1038/s41409-020-01124-6

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