Journal of Hematology, ISSN 1927-1212 print, 1927-1220 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Hematol and Elmer Press Inc
Journal website https://www.thejh.org

Case Report

Volume 12, Number 6, December 2023, pages 277-282

Refractory Pure Red Blood Cell Aplasia Secondary to Major ABO-Incompatible Allogeneic Stem Cell Transplantation Successfully Treated With Daratumumab

Figures

Figure 1.
Figure 1. The effect of pure red cell aplasia on patient’s BM: BM obtained on day +100 post allo-HSCT, and prior to starting treatment for PRCA. (a) Hematoxylin and eosin stain (magnification: × 100) showing decreased erythroid elements. (b) E-cadherin stain which highlighted decreased erythroid precursors (< 5% of total cells) with limited colony formation (magnification: × 200). (c) Myeloperoxidase stain which showed marked predominance of maturing granulocytic precursors (magnification: × 200). Allo-HSCT: allogenic hematopoietic stem cell transplant; BM: bone marrow; PRCA: pure red cell aplasia.
Figure 2.
Figure 2. Chronological timeline of patient’s hemoglobin and reticulocyte percentage post allo-HSCT. It highlights the response with various modalities. Allo-HSCT: allogenic hematopoietic stem cell transplant; BM: bone marrow; Hgb: hemoglobin; PRCA: pure red cell aplasia; Retic: reticulocyte.
Figure 3.
Figure 3. The effect of pure red cell aplasia on patient’s BM: BM obtained on day +184, after treatments with prednisone and rituximab. (a, b) Hematoxylin and eosin and E-cadherin stain re-demonstrating overall decreased erythroid elements accounting for < 10% of total cells and small colonies (magnification: × 200). (c) Myeloperoxidase stain continues to show predominance of maturing granulocytic precursors (magnification: × 200).