Chemotherapy-Induced Rhesus Blood Group Switch in Pleomorphic Sarcoma Patient during Non-Rhabdomyosarcoma Soft Tissue Sarcoma (NRSTS) Chemotherapy Protocol, Cycle 5

Abstract

Introduction: Changes in Rhesus blood group during cancer treatment are very rare. The Rhesus blood group is a genetic characteristic that usually remains for a lifetime. In this case, a child experiences a Rhesus change during treatment of pleomorphic sarcoma using Non Rhabdomyosarcoma Soft Tissue Sarcoma (NRSTS) therapy, which includes surgery, chemotherapy, and radiotherapy. The side effects of chemotherapy on red blood cells may cause changes to the Rhesus antigen. Case: A 17-year-old boy underwent chemotherapy with a history of blood transfusion for 9 times using A Rhesus negative blood. However, the latest crossmatch examination showed his blood group was weak A Rhesus positive. The patient was then given a transfusion of A Rhesus positive blood which was considered compatible. Before transfusion, the patient was given a corticosteroid injection premedication and monitored for 2 weeks. Conclusion: Pleomorphic sarcoma treatment, such as chemotherapy, has the potential to affect the expression of Rhesus antigen. Alkylating agents can replace hydrogen atoms with alkyl radicals, which can modify chemical groups and change the normal sequence of the polypeptide chain which can alter the expression of the Rhesus antigen.