TRANSFUSION MANAGEMENT OF AN IGA DEFICIENT PATIENT WITH ANTI-IGA AND INCIDENTAL CORRECTION OF IGA DEFICIENCY AFTER ALLOGENEIC BONE-MARROW TRANSPLANTATION

A patient with multiple myeloma was noted to have an IgA deficiency du ring investigation of a possible transfusion reaction due to IgA defic iency and anti-IgA, Because of the patient's age, otherwise good healt h, and early stage of disease, he was enrolled in a research treatment protocol that involved an allogeneic bone marrow transplant (BMT). Th e BMT successfully put the patient in complete remission from his mult iple myeloma and corrected his IgA deficiency, Class-specific IgG anti -IgA antibody that had been identified prior to BMT was no longer dete ctable in his plasma, Anaphylactic transfusion reactions were successf ully avoided by using a combination of IgA-deficient and washed blood components including the marrow graft, and IgA-reduced intravenous imm unoglobulin. (C) 1998 Wiley-Liss, Inc.