What is the indication for bone marrow and stem cell transplantation in the treatment of anemia?

Updated: Oct 08, 2018
  • Author: Joseph E Maakaron, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Bone marrow and stem cell transplantation have been used in patients with leukemia, lymphoma, Hodgkin lymphoma, multiple myeloma, myelofibrosis, and aplastic disease. Survival rates in these patients improved, and hematologic abnormalities were corrected. Allogeneic bone marrow transplantation has successfully corrected phenotypic expression of sickle cell disease and thalassemia and provided enhanced survival in patients who survived transplantation.

However, incomplete immune recovery after hematopoietic stem cell transplantation (HSCT) may predispose to autoimmune cytopenias, including anemia. From 2-6% of pediatric patients develop new-onset autoimmune hemolytic anemia (AIHA) after HSCT. Schuetz et al report that treatment with the anti-CD38 antibody daratumumab, which is approved for use in multiple myeloma, was curative in two of three patients with life-threatening posttransplant AIHA, with the third patient showing a transient response before relapse of AIHA 8 months afterward. [18]


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