COLD AGGLUTININ DISEASE FOLLOWING ALLOGENEIC BONE-MARROW TRANSPLANTATION

We describe a case of cold agglutinin disease (CAD) following allogene ic bone marrow transplantation. This 36-year-old male developed CAD 3 weeks after allogeneic bone marrow transplantation for chronic myeloge nous leukemia. Cyclosporin A and methotrexate had been administered to prevent graft-versus-host disease. Other agents administered included cytomegalovirus hyperimmune globulin and recombinant human G-CSF. Per icarditis preceded the development of CAD. The characterization of col d agglutinin (CA) was monoclonal IgM-kappa with anti-Pr antigen specif icity, probably derived from the engrafted donor lymphocytes. The admi nistration of prednisolone led to transient improvement. The CA titer decreased without further treatment 12 weeks after transplant.