Graft-versus-Host Disease after Intrauterine and Exchange Transfusions for Hemolytic Disease of the Newborn

Abstract

Fatal graft-versus-host disease developed in two immunologically normal infants after intrauterine and exchange transfusions for Rh-incompatible hemolytic disease of the newborn. In both cases, the diagnosis of graft-versus-host disease was established by the clinical and pathological features of the disease and the presence of lymphoid chimerism. The origin of the lymphocytes causing the graft-versus-host disease was demonstrated by karyotype analysis to be an exchange-transfusion donor in both cases. (N Engl J Med 290:359–363, 1974)