• Yeonjoo Choi, Ja Min Byun, Inho Kim, Jin Hyun Park, Ki Hwan Kim, Jin-Soo Kim, In Sil Choi, Min-Suk Yang, and Hyunkyung Park.
• Department of Hematology and Oncology, The Catholic University of Korea, St. Mary Incheon Hospital, Incheon, Republic of Korea.
• Medicine (Baltimore). 2021 Nov 5; 100 (44): e27724e27724.

RationaleAn allergic transfusion reaction is a common side effect of transfusions of red blood cells. Using washed red blood cells is the most effective method for preventing such a reaction. However, the availability of other washed transfusion components, including platelets, is limited.Patient ConcernsA 69-year-old patient with acute myeloid leukemia progressed from myelodysplastic syndrome and was treated with azacitidine. She experienced a minor reaction to platelet transfusion that initially responded to the administration of corticosteroids and antihistamines. However, she worsened even after subsequent preventive treatments and was referred to the emergency department due to anaphylaxis. The patient developed hypotension, chest pain, and dyspnea 10 minutes after the initiation of platelet transfusion.DiagnosesShe was diagnosed with platelet-induced anaphylaxis.InterventionsIn an attempt to prevent anaphylaxis, 150 mg of omalizumab was prescribed 1 week prior to transfusion. However, she experienced anaphylaxis again and was administered intramuscular epinephrine. For the following transfusion, we treated her with a 300 mg dose of omalizumab 24 hours before the transfusion.OutcomesShe tolerated well and continued to receive further chemotherapy and platelet transfusion with premedication.LessonsThis case suggests that omalizumab is a good candidate for the management of severe allergic transfusion reactions.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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