Molecular matching for Rh and K reduces red blood cell alloimmunisation in patients with myelodysplastic syndrome

Author(s)

Guelsin, Glaucia A. S. ^[1] ; Rodrigues, Camila ^[2] ; Visentainer, Jeane E. L. ^[2] ; Campos, Paula de Melo ^[1] ; Traina, Fabiola ^[1] ; Gilli, Simone C. O. ^[1] ; Saad, Sara T. O. ^[1] ; Castilho, Lilian ^[1]

Affiliation

^[1] Univ Estadual Campinas, UNICAMP, Hemoctr, BR-13081970 Campinas, SP - Brazil

^[2] Univ Estadual Maringa, Basic Hlth Sci Dept, Maringa, Parana - Brazil

• Document type: Journal article
• Source: BLOOD TRANSFUSION; v. 13, n. 1, p. 53-58, JAN 2015.
• Web of Science Citations: 7

Abstract

Background. Matching for Rh and K antigens has been used in an attempt to reduce antibody formation in patients receiving chronic transfusions but an extended phenotype matching including Fy(a) and JK(n) antigens has also been recommended. The aim of this study was to identify an efficient transfusion protocol of genotype matching for patients with myelodysplastic syndrome (MDS) or chronic myelomonocytic leukaemia. We also examined a possible association of HLA class II alleles with red blood cell (RBC) alloimmunisation. Materials and methods. We evaluated 43 patients with MDS undergoing transfusion therapy with and without antibody formation. We investigated antigen-matched RBC units for ABO, D, C, c, E. e, K, Fy(a), Fy(b), Jk(a), Jk(b), S, s, Do(a), Do(b) and Di(a) on the patients' samples and on the donor units serologically matched for them based on their ABO. Rh and K phenotypes and presence of antibodies. We also determined the frequencies of HLA-DRBI alleles in the alloimmunised and non-alloimmunised patients. Results. Seventeen of the 43 patients had discrepancies or mismatches for multiple antigens between their genotype-predicted profile and the antigen profile of the units of blood serologically matched for them. We verified that 36.8% of patients had more than one RBC alloantibody and 10.5% of patients had autoantibodies. Although we were able to find a better match for the patients in our extended genotyped/phenotyped units, we verified that matching for Rh and K would be sufficient for most of the patients. We also observed an over-representation of the HLA-DRBl{*}l3 allele in the non-alloimmunised group of patients with MDS. Discussion. In our population molecular matching for C. c, E, e, K was able to reduce RBC alloimmunisation in MDS patients. An association of HLA-DRBl{*}l3 and protection from RBC alloimmunisation should be confirmed. (AU)

• FAPESP's process: 12/04651-3 - Transfusion safety and immune response to red blood cell antigens in patients with sickle cell disease
• Grantee: Lilian Maria de Castilho
• Support type: Regular Research Grants
• 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 type: Scholarships in Brazil - Doctorate