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

Autor(es)

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]

Afiliação do(s) autor(es)

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

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

• Tipo de documento: Artigo Científico
• Fonte: BLOOD TRANSFUSION; v. 13, n. 1, p. 53-58, JAN 2015.
• Citações Web of Science: 7

Resumo

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)

• Processo FAPESP: 10/06916-9 - Polimorfismos de grupos sanguíneos em pacientes politransfundidos e portadores de anemia hemolítica auto-imune: implicações na resposta imune e na clínica transfusional.
• Beneficiário: Gláucia Andréia Soares Guelsin
• Modalidade de apoio: Bolsas no Brasil - Doutorado
• Processo FAPESP: 12/04651-3 - Segurança transfusional e resposta imune a antígenos eritrocitários em pacientes portadores de anemia falciforme
• Beneficiário: Lilian Maria de Castilho
• Modalidade de apoio: Auxílio à Pesquisa - Regular