Acute pain transfusion reaction (APTR)

Ready to upload
Record number: 
Adverse Occurrence type: 
MPHO Type: 
Estimated frequency: 
Estimated at 8% of all transfusion events.
Time to detection: 
20 minutes
Alerting signals, symptoms, evidence of occurrence: 
A 34-year-old woman with a diagnosis of hemophagocytic lymphohistocytosis (HLH) received a double umbilical cord blood transplantation following a myeloablative chemotherapy preparative regimen with busulfan and cyclophosphamide. On day 25 post-transplantation, the patient required a platelet transfusion for a platelet count of 6,000 per ml (normal range = 150,000-450,000 per ml). The patient's blood type prior to the cord blood transplantation was B positive and, although both umbilical cord blood donors were O positive, the patient was still B positive per blood bank testing on that day. Patient experienced excruciating pain in all of her joints. Erythema in the face and neck. After 15 minutes, the pain subsided and vital signs returned to normal.
Demonstration of imputability or root cause: 
Direct antiglobulin (DAT) was positive due to ABO mismatch.
Imputability grade: 
3 Definite/Certain/Proven
Groups audience: 
Suggest new keywords: 
Coombs test,
ABO, "ABO antibodies, hemolysis",
Reference attachment: 
Suggest references: 
Hardwick, J., Osswald, M. and Walker, D. (2013). Acute pain transfusion reaction. Oncol Nurs forum 40(6):543-545.