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Fatal graft-versus-host disease (GVHD) developed in a patient with Hodgkin's disease treated with combined chemotherapy and radiotherapy following the transfusion of 2 U of packed red blood cells. Clinical features of the GVHD included the development of exfoliative dermatitis, progressive hepatic dysfunction, aplastic anemia, and finally progressive fatal pneumonia. GVHD was documented by skin biopsy and chimerism by HLA typing. The HLA phenotype of the patient's skin fibroblasts [A3, Bw44 (w4)/A2, B15 (w4)] was appropriate for parental haplotypes and probably represented her true HLA phenotype. Lymphocytes from the patient (peripheral blood and lymph node biopsy) were of a different HLA phenotype (A3; Bw35, w38, w4, w6; Cw4), which was inappropriate for parental HLA haplotypes but identical to the HLA phenotype of one of the blood donors. The HLA-DR typing of the patient's family and of the blood donor demonstrated that the patient and the donor probably were HLA-DR identical (DRw5/DRw6), although no B lymphocytes could be obtained from the patient for direct DR typing. We are currently irradiating all blood products administered to patients with Hodgkin's disease receiving intensive treatment. Further observations will be necessary to determine whether transfusions to other cancer patients with immunodeficiency states should be restricted to irradiated blood products.
R E Dinsmore, and
D J Straus, and
M S Pollack, and
J M Woodruff, and
T J Garrett, and
C W Young, and
B D Clarkson, and
B Dupont
August 1990,
Nihon Geka Gakkai zasshi,
R E Dinsmore, and
D J Straus, and
M S Pollack, and
J M Woodruff, and
T J Garrett, and
C W Young, and
B D Clarkson, and
B Dupont
February 1981,
Pediatrics,
R E Dinsmore, and
D J Straus, and
M S Pollack, and
J M Woodruff, and
T J Garrett, and
C W Young, and
B D Clarkson, and
B Dupont
October 1994,
Transfusion,
R E Dinsmore, and
D J Straus, and
M S Pollack, and
J M Woodruff, and
T J Garrett, and
C W Young, and
B D Clarkson, and
B Dupont
September 1989,
Nihon Ketsueki Gakkai zasshi : journal of Japan Haematological Society,
R E Dinsmore, and
D J Straus, and
M S Pollack, and
J M Woodruff, and
T J Garrett, and
C W Young, and
B D Clarkson, and
B Dupont
September 2001,
Bone marrow transplantation,
R E Dinsmore, and
D J Straus, and
M S Pollack, and
J M Woodruff, and
T J Garrett, and
C W Young, and
B D Clarkson, and
B Dupont
November 1976,
Lancet (London, England),
R E Dinsmore, and
D J Straus, and
M S Pollack, and
J M Woodruff, and
T J Garrett, and
C W Young, and
B D Clarkson, and
B Dupont
June 1982,
The American journal of medicine,
R E Dinsmore, and
D J Straus, and
M S Pollack, and
J M Woodruff, and
T J Garrett, and
C W Young, and
B D Clarkson, and
B Dupont
February 2002,
Transplantation proceedings,
R E Dinsmore, and
D J Straus, and
M S Pollack, and
J M Woodruff, and
T J Garrett, and
C W Young, and
B D Clarkson, and
B Dupont
January 1985,
Medical and pediatric oncology,
R E Dinsmore, and
D J Straus, and
M S Pollack, and
J M Woodruff, and
T J Garrett, and
C W Young, and
B D Clarkson, and
B Dupont
January 1991,
Transfusion,
