References of "Gerard, Christiane"
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See detailEffet de la deleucocytation des concentres erythrocytaires sur les reactions transfusionnelles.
Mukagatare, I.; MONFORT, Mélanie ULg; de Marchin, J. et al

in Transfusion clinique et biologique : journal de la Societe francaise de transfusion sanguine (2010), 17(1), 14-9

SUBJECT: In order to assess the impact of leukocyte reduction, all transfusion reactions reported at Liege Teaching Hospital's Blood Bank 2 years before and after the implementation of universal leukocyte ... [more ▼]

SUBJECT: In order to assess the impact of leukocyte reduction, all transfusion reactions reported at Liege Teaching Hospital's Blood Bank 2 years before and after the implementation of universal leukocyte reduction of red blood cells concentrates which started-up on 1 January 2005 were evaluated. STUDY DESIGN AND METHODS: A retrospective analysis of transfusion reactions from 1 January 2003 to 31st December 2006 was undertaken. Data were collected from computerized reports, which were entered as soon as a transfusion reaction was reported. Symptoms were classified in different reaction's categories. Blood cultures, antibody screening and direct antiglobulin test were performed. Differences between the two time periods, before (2003-2004) and after (2005-2006) universal leukoreduction were determined by the Chi-square test and significance was defined as a p value less than 0.05. RESULTS: During period before the implementation of systematic leukoreduction, 68.7% of red blood cells transfused were leukoreduced. A total of 365 transfusion reactions in 91,996 red blood cells units transfused (0.4%) were reported, of which 266 were classified as febrile non-hemolytic transfusion reactions (72.9%), followed by allergic reactions (7.1%) and miscellaneous reactions (3.8%). When comparing the two-time periods, the rate of all transfusion reactions in general significantly decreased from 0.49 to 0.31% (p<0.001). Therefore, universal leukocyte reduction significantly reduced the rates of febrile non-hemolytic transfusion reactions (0.35% versus 0.24%; p=0.002) and allergic reactions (0.05% versus 0.01%; p<0.001). CONCLUSION: Universal leukocyte reduction significantly reduced the rate of transfusion reactions. [less ▲]

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See detailRh D foeto-maternal alloimmunization prophylaxis with anti-D immunoglobulins reviewed in the era of foetal RHD genotyping.
Minon, J. M.; Gerard, Christiane ULg; Schaaps, Jean-Pierre ULg et al

in Acta Clinica Belgica (2009), 64(3), 195-202

In Belgium, prevention of anti-D immunization is currently based on systematic postnatal prophylaxis associated with targeted antenatal injection in high-risk situations of foeto-maternal haemorrhage.The ... [more ▼]

In Belgium, prevention of anti-D immunization is currently based on systematic postnatal prophylaxis associated with targeted antenatal injection in high-risk situations of foeto-maternal haemorrhage.The failures of prevention are mainly due to the non-respect of established guidelines for RhlG prophylaxis, and to spontaneous undetected foetal-maternal haemorrhages without any obvious cause during the third trimester of pregnancy. In order to reduce the rate of residual post-pregnancy anti-D immunization, several countries decided to associate the classical prophylaxis to a routine antenatal anti-D prophylaxis (RAADP) during the 28th or 29th week of gestation. Since a few years, the foetal RHD genotyping in maternal plasma enables us to limit the antenatal prophylaxis only to those D- women carrying a D+ foetus. This paper deals with: the advantages of an antenatal prevention in the light of non-invasive foetal RHD genotyping, the rules rendering prevention protocols efficient whatever the algorithm applied, and the recommended immuno-haematology follow-up of women who received RhlG. [less ▲]

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See detailRoutine Fetal Rhd Genotyping with Maternal Plasma: A Four-Year Experience in Belgium
Minon, J. M.; Gerard, Christiane ULg; Senterre, J. M. et al

in Transfusion (2008), 48(2), 373-81

BACKGROUND: The objective was to evaluate the diagnostic value of RHD fetal genotyping from the plasma of D- mothers as soon as 10 weeks' gestation in a routine clinical practice in Belgium. STUDY DESIGN ... [more ▼]

BACKGROUND: The objective was to evaluate the diagnostic value of RHD fetal genotyping from the plasma of D- mothers as soon as 10 weeks' gestation in a routine clinical practice in Belgium. STUDY DESIGN AND METHODS: A prospective study was conducted between November 2002 and December 2006. DNA extraction was performed in an automated closed tube system. Fetal RHD/SRY genotypes were detected in the plasma of 563 pregnant mothers by real-time polymerase chain reaction (PCR) targeting multiple exons 4, 5, and 10 of the RHD gene and targeting an SRY gene sequence. These were compared to the D phenotypes determined in the 581 babies they delivered. RESULTS: By combining amplification of three exons, the concordance rate of fetal RHD genotypes in maternal plasma and newborn D phenotypes at delivery was 100 percent (99.8% including one unusual false-positive). The presence of nonfunctional RHD genes and the absence of a universal fetal marker, irrespective of fetal sex, did not influence the accuracy of fetal RhD status prediction. The RHD genotyping from 18 twin pregnancies was also assessed. Five weak D women were excluded from the RHD fetal genotyping prediction. Three discrepant results (0.5%) between predicted fetal genotype and cord blood phenotype were not confirmed by the baby phenotypes from venipuncture blood. CONCLUSION: Prenatal prediction of fetal RHD by targeting multiple exons from the maternal plasma with real-time PCR is highly sensitive and accurate. Over 4 years, this experience has highly modified our management of D- pregnant women. [less ▲]

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See detailPrevalence de l'infection par le VIH chez les femmes enceintes. Etude en milieu rural africain.
Mathe, M Kirere; Rigo, Jacques ULg; Sontag, Danièle et al

in Revue d'Epidémiologie et de Santé Publique (2008), 56(6), 407-13

BACKGROUND: The goal of the study is to assess the prevalence and risk factors of HIV in pregnant women in the North-East rural area of the Democratic Republic of Congo. METHODS: We undertook an ... [more ▼]

BACKGROUND: The goal of the study is to assess the prevalence and risk factors of HIV in pregnant women in the North-East rural area of the Democratic Republic of Congo. METHODS: We undertook an exploratory study on women attending the antenatal care during the study period (from December 2002 to December 2004) in the referral General hospital of the health catchments' area of Oicha (DRC). Women with gestational age equal or above 36 weeks were included in the study. After a first test using rapid test Abbott Determine locally, a second crossing check was performed in the referral HIV laboratory in Liege (Belgium). RESULTS: Among 5016 participants tested, 94 were positive (prevalence of 1.9% [CI95% 1.5-2.5]). Following factors predict a risk of being positive among participants: the statute of displacement (OR: 5.77; IC95%: 3.59-9.29); widowhood and divorces (OR: 4.47; IC95%: 1.47-13.60); mobility related to the profession of the husband (OR: 4.00; IC95%: 2.36-6,75); living the countryside (OR: 1.67; IC95%: 1.06-2.62; p: 0.0258). [less ▲]

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See detailNouvelles strategies dans la prise en charge de l'allo-immunisation foeto-maternelle anti-RHD (Rhesus)
Minon, J. M.; Gerard, Christiane ULg; Dricot, J. F. et al

in Revue Médicale de Liège (2006), 61(11), 756-62

Despite generalisation of anti-D immunoprophylaxis, RhD allo-immunisation still remains the major cause of severe haemolytic disease of the fetus and of the newborn (HDFN). The routine follow up of ... [more ▼]

Despite generalisation of anti-D immunoprophylaxis, RhD allo-immunisation still remains the major cause of severe haemolytic disease of the fetus and of the newborn (HDFN). The routine follow up of pregnant women comprises: the ABO/D, Rh/Kell red cells typing and the search for irregular antibodies. In case of anti-D immunisation, the paternal Rh phenotype, when known, provides useful information regarding the probability for the fetus to have inherited the D antigen and thereby to be exposed to the risk of HDFN. The antibody titre, which is predictive of possible in vivo haemolysis, must be interpreted in the light of the previous obstetric history, and can lead to the decision of invasive amniocentesis. Then the measurement of the optical density (deltaOD450 nm) and the fetal RhD typing can be realised on amniotic fluid. New molecular techniques make it possible now to demonstrate the presence of fetal DNA in maternal plasma. These methods lying on non invasive procedures could advantageously be applied to the genotyping of fetal RHD during pregnancy. The present paper aims to discuss the predictive values of RHD fetal genotype in maternal plasma of RhD negative mothers. The ante-partum management of immunised pregnant women is reviewed in the light of this new molecular approach combined to Doppler ultrasonography of the fetal middle cerebral artery. This non invasive method for determining fetal RHD genotype could be systematically proposed to all RhD negative pregnant women for a better targeted prenatal follow-up and an increased efficacy of RhD prophylaxis. [less ▲]

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See detailHCV genotype 4 in Belgium: three distinct patterns among patients from European and African origin
Delwaide, Jean ULg; Reenaers, Catherine ULg; Gerard, Christiane ULg et al

in European Journal of Gastroenterology & Hepatology (2006), 18(7), 707-712

Background Considered uncommon in western countries some years ago, hepatitis C virus of genotype 4 is now spreading in some areas of Europe. This is assumed to be due to immigration from a region of high ... [more ▼]

Background Considered uncommon in western countries some years ago, hepatitis C virus of genotype 4 is now spreading in some areas of Europe. This is assumed to be due to immigration from a region of high prevalence for this genotype and to propagation among drug users. In the south of Belgium, genotype 4 currently accounts for 10% of hepatitis C virus patients and its prevalence is increasing with time. Objective To better define the genotype 4 carriers' characteristics. Methods In a database comprising 1726 viraemic hepatitis C virus patients, the files of 85 genotype 4 carriers were reviewed. Results Beside the African (58%) and European drug user (15%) subgroups classically described, a third subgroup consisting of European nondrug users (26%) was identified as peculiar: these patients were older, had been mostly contaminated sporadically, presented a great diversity of subtypes, and were mainly of Italian origin. In this subgroup, contamination was supposed to be ancient, having occurred probably in Italy before immigration into Belgium. By contrast, European drug users were infected with only two subtypes (4c/4d and 4), an observation in favour of recent spread. Africans had a great diversity of subtypes, were young, and were mostly contaminated sporadically in their home countries. Despite their epidemiological differences, the clinical management, and in particular the rates of eligibility for treatment, were similar for these three groups. Conclusions Three different patterns of genotype 4 carriers were observed, corresponding to three different spreading profiles. They did not induce, however, different clinical management. [less ▲]

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See detailHepatitis C virus genotype 5 in southern Belgium: Epidemiological characteristics and response to therapy
Delwaide, Jean ULg; Gerard, Christiane ULg; Reenaers, Catherine ULg et al

in Digestive Diseases & Sciences (2005), 50(12), 2348-2351

Data are scarce on patients infected with hepatitis C virus of genotype 5, due to the low prevalence of this genotype around the world. To better define the characteristics of these patients, we reviewed ... [more ▼]

Data are scarce on patients infected with hepatitis C virus of genotype 5, due to the low prevalence of this genotype around the world. To better define the characteristics of these patients, we reviewed the files of 16 genotype 5 patients. Mean age was 38 +/- 14. All patients were of European origin. Most of them (75%) had been contaminated by transfusion within a short time period (between 1980 and 1991). There were no intravenous drug addicts. Seven patients received treatment. One patient did not respond to interferon (IFN) monotherapy. Of four patients treated with IFN and ribavirin, three became sustained viral responders. Two patients treated with pegylated IFN and ribavirin became sustained viral responders. In our region, genotype 5 patients seem to have been contaminated within a relatively short time period. Treatment with IFN or pegylated IFN and ribavirin gave a high rate (83%) of sustained viral responses. [less ▲]

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See detailHepatitis C infection: eligibility for antiviral therapies
Delwaide, Jean ULg; El Saouda, R.; Gerard, Christiane ULg et al

in European Journal of Gastroenterology & Hepatology (2005), 17(11), 1185-1189

Background Current treatments of chronic hepatitis C virus (HCV) are effective, but expensive and susceptible to induce significant side effects. Objectives To evaluate the proportion of HCV patients who ... [more ▼]

Background Current treatments of chronic hepatitis C virus (HCV) are effective, but expensive and susceptible to induce significant side effects. Objectives To evaluate the proportion of HCV patients who are eligible for a treatment. Methods In a database comprising 1726 viraemic HCV patients, the files of 299 patients who presented to the same hepatologist for an initial appointment between 1996 and 2003 were reviewed. Results Patients' characteristics were age 43.1 +/- 15.6 years, 53% male and 92% Caucasian. The main risk factors were transfusion (43%) and drug use (22%). Genotypes were mostly genotype 1 (66%), genotype 3 (12%) and genotype 2 (10%). These characteristics were not different from those of the whole series of 1726 patients. A total of 176 patients (59%) were not treated, the reasons for non-treatment being medical contraindications (34%), non-compliance (25%) and normal transaminases (24%). In addition, 17% of patients declined therapy despite being considered as eligible, mainly due to fear of adverse events. Medical contraindications were psychiatric (27%), age (22%), end-stage liver disease (15%), willingness for pregnancy (13%), cardiac contraindication (7%) and others (16%). Only 123 patients (41%) were treated. A sustained viral response was observed in 41%. The treatment was interrupted in 16% for adverse events. Conclusions The majority of HCV patients are not eligible for treatment. This implies that, with current therapies, only 17% of patients referred for chronic HCV become sustained responders. Some modifications of guidelines could extend the rate of treatment (patients with normal transaminases), but an important barrier remains the patients' and the doctors' fear of adverse events. [less ▲]

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See detailHCV genotypes 2 and 3: the predominant genotypes at the horizon 2020?
Delwaide, Jean ULg; Gerard, Christiane ULg; Vaira, Dolorès ULg et al

in Acta Gastro-Enterologica Belgica (2005, January), 68(1), 25

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See detailEvolution over a 10 year period of the epidemiological profile of 1,726 newly diagnosed HCV patients in Belgium.
Gerard, Christiane ULg; Delwaide, Jean ULg; Vaira, Dolorès ULg et al

in Journal of Medical Virology (2005), 76(4), 503-10

In order to evaluate the future burden of hepatitis C, there is a need to quantify the evolution with time of some crucial parameters such as disease frequency and age, modes of infection and infecting ... [more ▼]

In order to evaluate the future burden of hepatitis C, there is a need to quantify the evolution with time of some crucial parameters such as disease frequency and age, modes of infection and infecting genotypes of patients presenting for the first time at consultation. The yearly evolution of these parameters was analyzed retrospectively in a cohort of 1,726 patients living in Belgium, who were diagnosed as hepatitis C virus (HCV) carriers by polymerase chain reaction (PCR) between 1992 and 2002. The epidemiological profile of HCV patients showed significant changes during this period. The number of new patients increased with time. The proportion of patients under 50 increased linearly at a rate of 3% per year. The rate of newly presenting patients infected by transfusion before 1990 decreased, but only by 2.7% per year. The proportion of intravenous (IV) drug users increased by 2.5% per year. Patients presenting "undefined" risk factors increased by 2.1% per year. Nosocomial acquisition of HCV infection exhibited a disturbing relative stability in time whereas dialysis tended to disappear as a cause of infection. There was a significant linear annual decrease of 2.3% in the frequency of genotype 1b, which was counterbalanced by a significant increase of 0.7% for genotype 1a and 1.1% for genotype 4. Genotypes 2 and 3 did not vary significantly with time. Such figures are useful for evaluating the epidemiological changes of C virus infection and for anticipating the future economical cost of hepatitis C treatment in the next few years. [less ▲]

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See detailTreatment of acute hepatitis C with interferon alpha-2b: early initiation of treatment is the most effective predictive factor of sustained viral response
Delwaide, Jean ULg; Bourgeois, N.; Gerard, Christiane ULg et al

in Alimentary Pharmacology & Therapeutics (2004), 20(1), 15-22

AIM: To evaluate the efficacy of early interferon alpha-2b in non-post-transfusion acute hepatitis C virus: a prospective study with historical comparison. PATIENTS: Group A: 28 patients prospectively ... [more ▼]

AIM: To evaluate the efficacy of early interferon alpha-2b in non-post-transfusion acute hepatitis C virus: a prospective study with historical comparison. PATIENTS: Group A: 28 patients prospectively treated for acute hepatitis C virus with daily regimen of interferon 5 million units for 2 months. Group B: historical series of 16 patients with untreated acute hepatitis C virus. RESULTS: There was no significant difference between the two groups with regard to gender, age, icterus, alanine aminotransferase, or genotypes. In group B, hepatitis spontaneously resolved in three of 16 (19%) patients (follow-up 1-7 years). In group A, 21 of 25 patients became sustained viral responders (75%; P = 0.0003 vs. group B). Factors include not predictive of sustained viral response: age, gender, sources of infection, presence of icterus, alanine aminotransferase peak, bilirubin peak, incubation period, presence of hepatitis C virus antibodies at presentation, or genotypes. The time from presentation to the start of therapy was, however, significantly shorter in sustained viral responders (43 +/- 31 days) than in relapsers or non-responders (88 +/- 52 days) (P = 0.016). CONCLUSIONS: Early treatment of acute hepatitis C virus with interferon prevents chronicity. A short waiting time from presentation to treatment appears as the most relevant predictive factor for sustained response. [less ▲]

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See detailHpatitis C infection: eligibility for antiviral therapies
El souda, R; DELWAIDE, Jean ULg; GERARD, Christiane ULg et al

in Acta Gastro-Enterologica Belgica (2004), 67

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See detailHCV genotype 5: an easy to treat population
REENAERS, Catherine ULg; DELWAIDE, Jean ULg; GERARD, Christiane ULg et al

in Acta Gastro-Enterologica Belgica (2004), 67

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See detailHCV genotype 4 in Belgium: epidemiological characteristics
REENAERS, Catherine ULg; DELWAIDE, Jean ULg; GERARD, Christiane ULg et al

in Acta Gastro-Enterologica Belgica (2004), (67), 03

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See detailAnalyse de 516 rapports de reaction apres transfusion de produits sanguins labiles
Frere, M.C.; Rapaille, A.; Bouillenne, C. et al

in Transfusion Clinique et Biologique (2001), 8(4), 333-42

BACKGROUND: In order to assess the implemented preventive measures of transfusion reactions (TR) and to make a study of residual reactions, we analyzed 516 TR reports from 14 hospitals, for three years ... [more ▼]

BACKGROUND: In order to assess the implemented preventive measures of transfusion reactions (TR) and to make a study of residual reactions, we analyzed 516 TR reports from 14 hospitals, for three years since 1996 to 1998. METHODS: Clinical signs were classified according to seven etiologic categories. Systematic anti-erythrocyte and anti-leucocyte detection, as well as bacterial control of the returned bag were performed. RESULTS: The TR incidence is 3.7 per 1.000 products. Platelet concentrates (PC) provoke 7.4 TR per 1.000 transfusions, and red cell concentrates (RCC) 3.8. There are as many TR with apheresis platelets (AP), pre-storage leuco-depleted, as with random platelets, post-storage leuco-depleted, and as many with leuco-depleted RCC as with non leuco-depleted RCC. Leuco-depleted AP provoke more allergic reactions than other blood components. TR with AP are much more frequent in children than in adults. Plasma removal from AP before transfusion decreases reaction frequency. CONCLUSIONS: The lack in efficacy failure of pre-storage deleucocytation in TR prevention should be due to related patient factors. Etiology of AP allergic reactions deserves further study. PC suspension in synthetic medium before transfusion is an efficient means for RT decreasing. Hemovigilance system has to be improved so that all TR be reported. [less ▲]

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See detailComment je traite une ascite
Gielen, S.; Delwaide, Jean ULg; Detry, Olivier ULg et al

in Revue Médicale de Liège (2001), 56(12), 809-815

Ascites is the most common of the major complications of cirrhosis. The initial evaluation of a patient with ascites should include a history, physical evaluation and some investigations. Treatment should ... [more ▼]

Ascites is the most common of the major complications of cirrhosis. The initial evaluation of a patient with ascites should include a history, physical evaluation and some investigations. Treatment should consist of treating the underlying liver disease, sodium restricted diet (2 g of Na+/day) and diuretics. This regimen is effective in 90 % of patients. The treatment options for the diuretic-resistant patients include serial therapeutic paracentesis, peritoneovenous shunting, TIPSand liver transplantation. The treatment and prophylaxis of spontaneous bacterial peritonitis which is a frequent and severe complication in cirrhotic patients with ascites is also important. The differential diagnosis with secondary bacterial peritonitisis is essential because the latter usually does not resolve unless patients are surgically treated. [less ▲]

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See detailEvidence-Based Medicine: traitement de l'hépatite chronique C. GLEVHE. Groupe Liégeois d'Etude des Virus Hépatotropes.
Delwaide, Jean ULg; Gerard, Christiane ULg; Belaiche, Jacques ULg et al

in Revue Médicale de Liège (2000), 55(5), 337-340

The Hepatitis C virus (HCV) infects nearly 170 million people in the world. The major characteristic of virus C is its tendency to chronicity in more than 85% of cases. Generally asymptomatic, HCV ... [more ▼]

The Hepatitis C virus (HCV) infects nearly 170 million people in the world. The major characteristic of virus C is its tendency to chronicity in more than 85% of cases. Generally asymptomatic, HCV infection may also evolve with time to cirrhosis and hepatocellular carcinoma. During the last few years, HCV-related end-stage cirrhosis has become the first cause of liver transplantation. In 10 years only, very significant progress has been made in the knowledge of the virus, not only in the field of diagnosis but also in therapy. Several consensus conferences taking last discoveries into account have been organized in order to promote recommendations useful for the management of hepatitis C patients. The aim of this short overview is to summarize practical recommendations that emerged recently from consensus meetings. [less ▲]

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See detailTreatment of acute hepatitis C with interferon alpha 2b prevents chronicity.
Delwaide, Jean ULg; Bourgeois, N.; Gerard, Christiane ULg et al

in Gut (2000), 47(3), 14

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See detailTreatment of acute hepatitis C with interferon alpha-2b prevents chronicity.
Delwaide, Jean ULg; Bourgeois, N.; Gerard, Christiane ULg et al

in Hepatology (Baltimore, Md.) (1999), 30(4), 413

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See detailDelayed massive immune hemolysis mediated by minor ABO incompatibility after allogeneic peripheral blood progenitor cell transplantation.
Salmon, Jean ULg; Michaux, S.; Hermanne, J. P. et al

in Transfusion (1999), 39(8), 824-7

BACKGROUND: Bone marrow transplantation with minor ABO incompatibility may be followed by moderate delayed hemolysis of the recipient's red cells by donor-derived ABO antibodies. This reaction may be more ... [more ▼]

BACKGROUND: Bone marrow transplantation with minor ABO incompatibility may be followed by moderate delayed hemolysis of the recipient's red cells by donor-derived ABO antibodies. This reaction may be more severe after transplantation of peripheral blood progenitor cells (PBPCs). CASE REPORT: A 16-year-old boy underwent an allogeneic PBPC transplant from his HLA-mismatched mother as treatment for acute myeloblastic leukemia that had proved resistant to induction chemotherapy. Transfusion of the unmanipulated PBPCs proceeded without any complication, despite the difference in ABO blood group (donor, O Rh-positive; recipient, A Rh-positive). On Day 7, a rapid drop in hemoglobin to 4 g per dL was observed, which was attributed to a massive hemolysis. All the recipient's group A red cells were destroyed within 36 hours. This delayed and rapidly progressive hemolytic anemia was not associated with the transfusion of the donor's plasma. Rather, the anti-A titer increased in parallel with marrow recovery, which suggested an active synthesis of these antibodies by immunocompetent cells from the donor against the recipient's red cells. The mother's anti-A titer was retrospectively found to be 2048. Her unusually high titer is probably due to prior sensitization during pregnancies. On Day 12, the patient developed grade IV graft-versus-host disease, which proved resistant to all treatments instituted and led to his death on Day 35. CONCLUSION: PBPC transplantation with minor ABO incompatibility may be associated with significant risk of massive delayed hemolysis. [less ▲]

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