Red cell allo immunization

BACKGROUND: Fetomaternal Rhesus incompatibility is a medical condition that affects the pregnant woman [of blood group (A, B, AB, O) and a negative Rhesus] and the foetus (of positive Rhesus). The objective of this study is to determine the prevalence and to present the clinical characteristics of fetomaternal Rhesus incompatibility in a tertiary care hospital. METHODS: The authors conducted a retrospective cross-sectional study and 37 participants were recorded during the study period of 4 years...

BACKGROUND: Blood transfusion in the perioperative cardiothoracic setting has accepted risks including deep sternal wound infection, increased intensive care unit length of stay, lung injury, and cost. It has an immunomodulatory effect which may cause allo-immunisation. This may influence long-term survival through immune-mediated factors. Targeting coagulation defects to reduce unnecessary or inappropriate transfusions may reduce these complications. METHODS: In 2012, an institution-wide patient blood management evidence-based algorithmic bleeding management protocol was implemented at The Prince Charles Hospital, Brisbane, Australia...

BACKGROUND: The DEL phenotype is the D variant expressing the least amounts of D antigen per red cell. Asian-type DEL (RHD:c.1227G > A) is the most prevalent DEL in East Asia without any anti-D alloimmunization reported before. We investigated the first observation of an anti-D in any DEL phenotype, reported in the Japanese language at a 1987 conference, only 3 years after the discovery of DEL. METHODS: We contacted the proband 35 years after the initial report...

Hemolytic disease of the fetus and newborn is a syndrome associated with immune destruction of the fetal and newborn red cells by maternal red cell alloantibodies. The detection of anti-M in antenatal screening can be responsible for neonatal red cell aplasia. A 32-h-old full-term neonate admitted with inconsolable cry and mild fever. Laboratory tests revealed progressive anemia and hyperbilirubinemia on day 3. The peripheral blood smear showed evidence of hemolysis and reticulocyte count was reduced. Intensive phototherapy and antibiotics were started after ruling out other causes of hyperbilirubinemia...

Background and aims: How to select the treatment is a challenge for the management of acquired patients with infections. This study aimed at comparing the outcomes of SAA with infections who had an allogeneic hematopoietic stem cell transplantation (allo-HSCT)with that of patients who had an infection and received non-HSCT therapy. Methods: We retrospectively compared the outcomes of patients with acquired SAA and infections who had an allo-HSCT ( n = 141) with that of patients who had an infection and received non-HSCT therapy (n = 186) between July 2004 and January 2020...

Background: An analysis of red blood cell alloimmunization in patients with thalassemia can help to devise specific strategies to decrease the alloimmunization rate. This study explored the frequency and specificity of alloantibodies and autoantibodies against red blood cell (RBC) antigens in patients with thalassemia referring to the Iranian Blood Transfusion Organization (IBTO) Immunohematology Reference Laboratory (IRL) in Tehran. Materials and Methods: This study first examined the laboratory records of 23,113 patients suffering from different diseases referring to IBTO's IRL for pretransfusion testing in the 2008-2015 period...

Inflammatory monocytes are a major component of the cellular infiltrate in acutely rejecting human kidney allografts. Since immune-modifying nanoparticles (IMPs) bind to circulating inflammatory monocytes via the specific scavenger receptor MARCO, causing diversion to the spleen and subsequent apoptosis, we investigated the therapeutic potential of negatively charged, 500-nm diameter polystyrene IMPs to prevent kidney allograft rejection. Kidney transplants were performed from BALB/c (H2d ) to C57BL/6 (H2b ) mice in two groups: controls (allo) and allo mice infused with IMPs...

BACKGROUND AND OBJECTIVES: Most myelodysplastic syndromes (MDS) patients become red blood cell (RBC) transfusion-dependent. Transfusing MDS patients with prophylactically RH-KEL1 antigen-matched (PAM) RBC units is recommended to avoid RBC allo-immunization. D+C-E-c+e+, D+C-E+c+e- and D+C+E-c-e+ phenotypes are infrequent among French blood donors. To preserve infrequent phenotype RBC units for patients other than MDS, and to manage frequent phenotype RBC unit stocks, we let, for 1 year, higher-risk non-immunized chronically transfused MDS and acute myeloid leukaemia (AML) patients receive RBC transfusions matched only for D...

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only currently available curative treatment for sickle cell disease (SCD). However, the effects of HSCT on SCD pathophysiology are poorly elucidated. Here, we assessed red blood cell (RBC) adhesiveness, intensity of hemolysis, vascular tone markers and systemic inflammation, in SCD patients treated with allogeneic HSCT. Thirty-two SCD patients were evaluated before and on long-term follow-up after HSCT. Overall survival was 94% with no severe (grade III-IV) graft- vs -host disease and a 22% rejection rate (graft failure)...

Passenger lymphocyte syndrome (PLS) is a specific subtype of graft versus host disease (GVHD) following allogeneic hematopoietic stem cell transplantation (allo-HSCT) characterized by an immune-mediated hemolysis caused by donor-derived B cells. However, precise nature of PLS has not been well characterized due to its rarity. We herein report two cases of PLS following ABO-incompatible HSCT whose clinical course and dynamics of anti-ABO allo-antibody and blood type conversion were closely examined. Both cases demonstrated acute hemolysis upon engraftment, and the presence of high titer allo-antibody against recipients' red blood cells (RBCs) helped us to reach the diagnosis of PLS...

The red cell allo-antibodies research is mandatory before transfusion. In France, pretransfusion testing intervals that are prescribed by regulatory and accrediting agencies are commonly 72 hours. In the University hospital of Brest, the interval for multi-transfused patients has been 24 hours. In this study we aim to analyse these practice and argue the delay. Methods This is a retrospective study of post-transfusional allo-immunizations from 2015 to 2020. For each patient, the time interval between the last negative research and the allo-immunization was investigated...

Patients with sickle cell disease often undergo frequent blood transfusions. This increases their exposure to red blood cell alloantigens of donor units, thus making it more likely that they produce alloantibodies. This cross-sectional study aimed to describe the prevalence of allo-immunization in patients with sickle cell disease who were monitored at Cayenne Hospital in 2016. Of the 451 patients recruited during the study period, 238 (52.8%) were female. There were 262 (58.1%) homozygous sickle cell and 151 (33...

INTRODUCTION: Immune checkpoint inhibitors (ICI) have become a primary treatment modality for patients with a variety of malignancies. Given their increasing use, it is essential to be familiar with their immune-related adverse events (irAEs). Here we report a severe case of autoimmune hemolytic anemia (AIHA) associated with cold agglutinin precipitated by pembrolizumab, and a retrospective study of patients treated with ICI utilizing an institutional database where we analyzed the patterns of anti-RBC testing and their ability to predict irAE...

BACKGROUND: Antibodies to the Kidd blood group are mainly red blood cell (RBC) immune, but a few reports on naturally occurring antibodies have been documented. AIM: The aim of this study is to study the anti-Jk(a) for its unusual reactivity with different serological methods. MATERIALS AND METHODS: Donor's plasma was tested with RBCs from in house donors and commercial panels by manual and automated devices. RESULTS: A 36-year-old male blood donor with naturally occurring anti-Jk(a) is detected by solid-phase assays and the gel card technique but not by the tube method...

This scientific article emphasizes the importance of a policy for antibody screening of all blood donors as a step to further improve blood safety. We also report the incidence of red blood cell (RBC) alloimmunization in healthy blood donors obtained using a cross-sectional prospective study from September 2017 to January 2019 in the Department of Transfusion Medicine of a tertiary care referral and teaching institute in northern India. The indirect antiglobulin test (IAT) for unexpected RBC antibodies was performed by the conventional tube test with pooled group O RBCs on all donor units irrespective of their D status...

BACKGROUND AND OBJECTIVES: Alloantibodies against red-blood-cell (RBC) antigens often coincide with alloantibodies against leucocytes and platelets and sometimes with autoantibodies towards various antigens. Chimerism may be one of the factors responsible for the combination of allo- and autoantibodies. Women with alloantibodies against RBC antigens causing haemolytic disease of the fetus and neonate may need to receive intrauterine transfusions. These transfusions increase not only maternal antibody formation but also fetomaternal bleeding and may enhance fetal chimerism...

Despite excellent transplant outcomes of aplastic anemia (AA) in developed countries, management in developing countries is challenging because of delay in the diagnosis, use of family donors for transfusions, and higher infection risk pretransplant. These factors can lead to allo-immunization, increased risk of graft failure, graft-versus-host disease (GVHD), and transplant-related mortality, leading to unfavorable outcomes. Conventional cyclophosphamide (Cy) and antithymocyte globulin (ATG) are associated with inferior overall survival in such high-risk patients...

Sickle cell disease (SCD) is the most prevalent genetic disorder in France. Many other countries are also affected. Transfusion is still a key treatment for patients suffering from this condition. As a result, SCD patients are much more exposed to transfusions and their risks than the general population. The most feared situation is delayed hemolytic transfusion reaction (DHTR). In certain situations, defined as hyperhemolysis, autologous red blood cells (RBCs) are also targeted and destroyed. This can put the patient in a life-threating situation...

Immuno-hematological follow up of pregnant women. The goal of immuno-hematological follow-up during pregnancy is to organize maternal transfusion safety and optimal management of fetal and neonatal hemolytic disease, that may result from maternal immunization. This follow-up relies on scheduled antibodies detection following regulation. Since May 2017 the refund by social security of the fetal RHD genotyping analysis on maternal plasma, it is possible to limit prophylaxis of allo-immunization to RhD-negative women with a RhD positive fetus...

OBJECTIVE: Erythrocyte allo-immunization's rate has decreased but without adapted treatment the prognosis is still poor. The aim of our study was to evaluate the fetal prognosis, the complication's rate and the risk factors of complications of the intrauterine transfusion. METHODS: Retrospective study about 37 fetus and 86 intrauterine transfusions between 2001 and 2017. Our main criterion in judging was the occurrence of procedure related complications: premature membrane rupture or premature delivery within seven days from the procedure, chorioamnionitis, abnormal fetal heart rate indicating an emergency ceasarean section within the 24hours from the procedure, in utero death or neonatal death related to the procedure...