Blood group and HLA polymorphisms in patients with myelodysplastic syndrome and their implications in erythrocyte alloimmunization

Author(s)

Gláucia Andréia Soares Guelsin

• Document type: Doctoral Thesis
• Press: Campinas, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas
• Defense date: 2014-02-26

Examining board members

Lilian Maria de Castilho; Ana Maria Sell; Wilson Baleotti Junior; Marcelo Addas de Carvalho; Angela Cristina Malheiros Luzo

• Advisor: Lilian Maria de Castilho; Jeane Eliete Laguila Visentainer

Abstract

The myelodysplastic syndrome (MDS) is a group of heterogeneous clonal disorder caused by an intrinsic stem cell defect with propensity to the bone marrow failure that results in the transfusion dependence and neutropenic infection. Although blood transfusion is generally safe, many of those patients are at risk of transfusion-related complications such as iron overload and RBC alloimmunization that often makes finding compatible RBC products difficult and is also associated with delayed hemolytic transfusion reactions (DHTRs) and autoantibody formation. Matching for Rh and K antigens has been used in an attempt to reduce antibody formation in patients receiving chronic transfusions but an extended phenotyping matching including Fya and Jka antigens has also been recommended. This study was aimed to identify the transfusion profile of the patients with myelodysplastic syndrome (MDS), an efficient transfusion protocol of genotype matching and a possible association of HLA class alleles with susceptibility or protection to RBC alloimmunization. We evaluated 61 patients with MDS, 18 not transfused and 43 undergoing transfusion therapy with and without antibody formation. We performed genotyping for RHD, RHCE, FY, DO, CO, DI, SC, GYPA, GYPB, LU, KEL, JK e LW and for HLA class I and class II alleles in the patient DNA samples and compared the results with a control group. We verified that the majority of patients have regular transfusions and 44% are alloimmunized to RBC antigens. Blood group genotyping was superior to phenotyping to determine the antigen profile in those patients and molecular matching for Rh and K would be enough for most of the patients. Our results also showed a significant association of HLA-DRB1*13 with protection to RBC alloimmunization in patients with MDS (AU)

• FAPESP's process: 10/06916-9 - Blood groups polymorphisms in patients with multiple transfusions and patients with autoimmune hemolytic anemia: implications in immune response and transfusion practice.
• Grantee: Gláucia Andréia Soares Guelsin
• Support Opportunities: Scholarships in Brazil - Doctorate