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Multiple hematopoietic progenitor cell (HPC) transplantation options for patients with sickle cell disease (SCD) are currently under investigation. Patients with SCD have a high rate of alloimmunization to red blood cell antigens, often complicating transfusion support. Transfusion reactions, including acute and delayed hemolytic reactions, have been observed despite immunosuppressive regimens. Allogeneic donor transplants have been shown to carry a risk of prolonged reticulocytopenia and acute hemolysis with severe anemia in nonmyeloablative regimens. We discuss our experience providing transfusion support to patients with SCD undergoing HPC transplantation, propose an outline for a complete pretransplantation evaluation, and discuss donor/recipient compatibility issues and their implications. [ABSTRACT FROM AUTHOR]

A case study is presented of a 36-year-old woman with relapsed leukemia and severe neutropenia. She received acetaminophen and diphenhydramine, with one single-donor platelet unit followed by a red blood cell (RBC); after second unit of RBC patient developed rigors with temperature, tachycardia, and hypotension, further delayed presentation of septic transfusion reaction incidence was identified in the paitent.