Abstract
BACKGROUND: Passenger lymphocyte syndrome (PLS) is most often a result of an ABO minor mismatch between stem cell or solid organ donor and recipient. Relatively few cases of PLS have been reported resulting from non-ABO red cell antibodies. CASE REPORT: A blood group O/Rh-positive patient received a stem cell transplant from an A/Rh-negative donor who had an identifiable anti-D. Even though the plasma of the stem cell product was reduced and replaced with an electrolyte solution, the recipient developed a positive antibody screen, positive direct antiglobulin test, and significant hemolysis 8 days after transplantation. CONCLUSION: PLS can result from non-ABO antibodies and can be associated with a significant degree of hemolysis.