[en] Conventional pretransfusion testing based on hemagglutination assays can be challenging for patients with autoimmune hemolytic anemia (AIHA) because of the presence of auto-antibodies. It has been suggested that deoxyribonucleic acid-based methods could be more efficient in the selection of antigen-matched red blood cell units in those settings. Because of the high risk of alloimmunization of these patients and the labor-intensive nature of adsorption techniques, we decided to evaluate the feasibility of selecting antigen-matched units on the basis of RBC genotyping. We included in our routine RBC genotyping program samples from 7 patients with AIHA presenting a strongly positive direct antiglobulin test. This made the routine compatibility tests difficult. Most patients had previously received transfusions because of warm AIHA. Matched donor units were selected according to the genotype. For all but 1 patient, blood group genotyping could be done on time to allow antigen-matched transfusion. Four patients received antigen-matched red blood cell units based on RBC genotyping and for 1 patient the fact that no matched units were available led us to postpone the transfusion. After each transfusion, the recovery was recorded and considered satisfactory for all transfused patients.
Disciplines :
Hematology
Author, co-author :
El Kenz, Hanane
Efira, Andre
Le, Phu Quoc
Thiry, Claire
Valsamis, Joseph
Azerad, Marie-Agnès ; Centre Hospitalier Universitaire BRUGMANN- BRUXELLES > Département de médecine interne > Service d'hématologie clinique
Corazza, Francis
Language :
English
Title :
Transfusion support of autoimmune hemolytic anemia: how could the blood group genotyping help?
Publication date :
2014
Journal title :
Translational Research: the Journal of Laboratory and Clinical Medicine
ISSN :
1931-5244
eISSN :
1878-1810
Publisher :
Elsevier, Netherlands
Volume :
163
Issue :
1
Pages :
36-42
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright (c) 2014 Mosby, Inc. All rights reserved.
D.R. Branch, and L.D. Petz Detecting alloantibodies in patients with autoantibodies Transfusion 39 1999 6 10 (Pubitemid 29065953)
R.M. Leger, and G. Garatty Evaluation of methods for detecting alloantibodies underlying warm autoantibodies Transfusion 39 1999 11 16 (Pubitemid 29065954)
D.R. Branch, and L.D. Petz A new reagent (ZZAP) having multiple applications in immunohematology Am J Clin Pathol 78 1982 161 167 (Pubitemid 12057074)
M.A. Wallhermfechtel, B.A. Pohl, and H. Chaplin Alloimmunization in patients with warm autoantibodies: a retrospective study employing three donor alloabsorptions to aid in antibody detection Transfusion 24 1984 482 485 (Pubitemid 15193812)
P. James, G.P. Rowe, and G.G. Tozzo Elucidation of alloantibodies in autoimmune haemolytic anaemia Vox Sang 54 1988 167 171
R.J. Sokol, S. Hewitt, D.J. Booker, and B.M. Morris Patients with red cell autoantibodies: selection of blood for transfusion Clin Lab Haematol 10 1988 257 264
M.L. Laine, and K.M. Beattie Frequency of alloantibodies accompanying autoantibodies Transfusion 25 1985 545 546 (Pubitemid 16174464)
P.D. Issitt, P.R. Combs, D.J. Bumgarner, J. Allen, A. Kirkland, and H. Melroy-Carawan Studies of antibodies in the sera of patients who have made red cell autoantibodies Transfusion 36 1996 481 486 (Pubitemid 26234628)
C.K. Cheng, M.L. Wong, and A.W. Lee PEG adsorption of autoantibodies and detection of alloantibodies in warm autoimmune hemolytic anemia Transfusion 41 2001 13 17 (Pubitemid 32142239)
J. Cid, X. Ortin, A. Pinacho, R. Parra, E. Contreras, and E. Elies Use of polyethylene glycol for performing autologous adsorptions Transfusion 45 2005 694 697 (Pubitemid 40656380)
E.P. Laine, R.M. Leger, P.A. Arndt, L. Calhoun, G. Garatty, and L.D. Petz In vitro studies of the impact of transfusion on the detection of alloantibodies after autoadsorption Transfusion 40 2000 1384 1387
R.S. Shirey, J.S. Boyd, A.V. Parwani, W.S. Tanz, P.M. Ness, and K.E. King Prophylactic antigen-matched donor blood for patients with warm autoantibodies: an algorithm for transfusion management Transfusion 42 2002 1435 1441
M.E. Reid, and G.E. Denomme DNA-based Methods in the Immunohematology Reference Laboratory Transfu Apher Sci 44 2001 65 72
D.J. Anstee Red cell genotyping and the future of pretransfusion testing Blood 114 2009 248 256
S. Kappler-Gratias, T. Peyrard, and M. Beolet Blood group genotyping by high-throughput DNA analysis applied to 356 reagent red blood cell samples Transfusion 51 2011 36 42
B.N. Pham, M. Roussel, and T. Peyrard Anti-D investigations in individuals expressing weak D Type 1 or weak D Type 2: allo- or autoantibodies? Transfusion 51 2011 2679 2685
H. Schonewille, R.R. de Vries, and A. Brand Alloimmune response after additional red blood cell antigen challenge in immunized hemato-oncology patients Transfusion 49 2009 453 457
G. Garratty Drug-induced immune hemolytic anemia Hematology Am Soc Hematol Educ Program 1 2009 73 79