Posttransfusion graft-versus-host disease in Japanese newborns - PubMed (original) (raw)

Review

Posttransfusion graft-versus-host disease in Japanese newborns

H Ohto et al. Transfusion. 1996 Feb.

Abstract

Background: Posttransfusion graft-versus-host disease (PT-GVHD) is underdiagnosed and underreported. Risk factors predisposing to PT-GVHD in newborn recipients, the clinical manifestations of the disease in newborns, and its mechanism are not well characterized.

Study design and methods: A literature review identified 27 cases of PT-GVHD in newborns in Japan. Detailed information on volume of blood transfused, donor(s), and clinical course was analyzed. Infants with known immunodeficiency were excluded.

Results: Of 27 newborns, 20 were premature and 7 were full-term. Thirteen premature neonates were transfused frequently because of anemia; in 10 cases, exchange transfusion was performed. Fresh blood (<or=72 hours after donation) and blood from family member(s) were transfused to 25 and 22 neonates, respectively. The clinical manifestations of PT-GVHD developed later after transfusion than is reported in adults; the median intervals were: fever, 28 days; erythematous rash, 30 days; leukopenia, 43 days; and death, 51 days. Thymic damage was a striking feature among newborns. Two thirds of the cases of PT-GVHD were associated with overwhelming infections, and all patients died in spite of various treatments.

Conclusion: These data suggest that cellular blood components, especially those from family members, should be irradiated before transfusion to premature and full-term neonates. Extrathymic and/or thymic semitolerance for allogeneic-donor cytotoxic T-lymphocytes may explain the longer period of latency before the onset of clinical manifestations and the longer course of disease before death in newborns than are noted in adults, as well as the fewer than expected reported cases of PT-GVHD in neonates.

PubMed Disclaimer

Comment in

Transfusion-associated graft-versus-host disease in the neonate-expanding the spectrum of disease.
Luban NL, DePalma L. Luban NL, et al. Transfusion. 1996 Feb;36(2):101-3. doi: 10.1046/j.1537-2995.1996.36296181918.x. Transfusion. 1996. PMID: 8614956 No abstract available.

Cited by

Transfusion associated GVHD.
Sohi I, Jacob S. Sohi I, et al. Indian J Pediatr. 2005 Jun;72(6):533-5. doi: 10.1007/BF02724436. Indian J Pediatr. 2005. PMID: 15985746
Neonatal erythroderma: differential diagnosis and management of the "red baby".
Hoeger PH, Harper JI. Hoeger PH, et al. Arch Dis Child. 1998 Aug;79(2):186-91. doi: 10.1136/adc.79.2.186. Arch Dis Child. 1998. PMID: 9797607 Free PMC article. Review. No abstract available.
The immunocompromised patient and transfusion.
Badami KG. Badami KG. Postgrad Med J. 2001 Apr;77(906):230-4. doi: 10.1136/pmj.77.906.230. Postgrad Med J. 2001. PMID: 11264483 Free PMC article. Review. No abstract available.
Umbilical Cord Blood and Cord Tissue-Derived Cell Therapies for Neonatal Morbidities: Current Status and Future Challenges.
Zhou L, McDonald C, Yawno T, Jenkin G, Miller S, Malhotra A. Zhou L, et al. Stem Cells Transl Med. 2022 Mar 17;11(2):135-145. doi: 10.1093/stcltm/szab024. Stem Cells Transl Med. 2022. PMID: 35259278 Free PMC article.
Recommendations on Selection and Processing of RBC Components for Pediatric Patients From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative.
Zantek ND, Parker RI, van de Watering LM, Josephson CD, Bateman ST, Valentine SL, Delaney M; Pediatric Critical Care Transfusion and Anemia Expertise Initiative (TAXI); Pediatric Critical Care Blood Research Network (BloodNet), and the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network. Zantek ND, et al. Pediatr Crit Care Med. 2018 Sep;19(9S Suppl 1):S163-S169. doi: 10.1097/PCC.0000000000001625. Pediatr Crit Care Med. 2018. PMID: 30161072 Free PMC article.

Posttransfusion graft-versus-host disease in Japanese newborns - PubMed (original) (raw)