항-e 항체가 ABO 부적합 조혈모세포이식 후 공여자 유래 림프구에 의해 생성된 항-E+c로 변경된 1예 = Change from Anti-e to Anti-E+c Produced by Donor B Lymphocytes After ABO-incompatible Hematopoietic Stem Cell Transplantation: A Case Report

다국어 초록 (Multilingual Abstract)

Unexpected red blood cell alloantibodies are relatively uncommon in patients who undergo hematopoietic stem cell transplantation (HSCT). Little is known about the origin of the immune cells responsible for the production of these alloantibodies in patients living in Korea. Here, we report the case of a 41-year-old female with anti-E and anti-c antibodies detected 20 months after receiving an ABO-incompatible HSCT. The previously identified anti-e antibody was no longer detectable. Engrafted donor B lymphocytes were implicated as the origin of the newly detected alloantibodies. This case demonstrates the importance of monitoring unexpected antibodies before and after HSCT.

국문 초록 (Abstract)

ABO 불일치 조혈모세포이식 후 적혈구 비예기항체는 드물게 생성된다. 게다가 이들 항체를 생성한 면역세포의 기원을 설명한 연구는 그간 국내에서는 없었다. 저자들은 이식 전 항-e 항체가 동정된 41세 재생불량빈혈 환자에서 ABO 양방향부적합 동종조혈모세포이식 후 기존 항체는 사라지고, 이식 후 20개월이 지나 항-E 및 항-c 항체가 새롭게 발견되어 보고한다. 동종 조혈모세포이식 후 생성된 항체는 이식 후 성숙된 기증자 B 림프구에서 기원한 것으로 추정된다. 본 증례를 통해 이식 전후 비예기항체의 모니터링이 중요함을 알 수 있다.

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