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Jingchun Liu, Manjula Santhanakrishnan, Prabitha Natarajan, David R Gibb, Stephanie C Eisenbarth, Christopher A Tormey, Alexa J Siddon, Sean R Stowell, Donald R Branch, Jeanne E Hendrickson
RBC alloimmunization is a serious complication of transfusion or pregnancy. Despite the widespread use of RhIg to prevent pregnancy associated anti-D alloimmunization, its mechanism of action remains elusive. We have previously described a murine model in which immunoprophylaxis with polyclonal anti-KEL sera prevents alloimmunization in wild type recipients transfused with transgenic murine RBCs expressing the human KEL glycoprotein. To investigate the mechanism of action, we have now evaluated the outcome of immunoprophylaxis treatment in mice lacking Fcγ receptors (FcγR), complement (C3), both, or none...
September 29, 2016: Blood
Lohith S Bachegowda, Yan H Cheng, Thomas Long, Beth H Shaz
Context .- Substantial variability between different antibody titration methods prompted development and introduction of uniform methods in 2008. Objective .- To determine whether uniform methods consistently decrease interlaboratory variation in proficiency testing. Design .- Proficiency testing data for antibody titration between 2009 and 2013 were obtained from the College of American Pathologists. Each laboratory was supplied plasma and red cells to determine anti-A and anti-D antibody titers by their standard method: gel or tube by uniform or other methods at different testing phases (immediate spin and/or room temperature [anti-A], and/or anti-human globulin [AHG: anti-A and anti-D]) with different additives...
September 28, 2016: Archives of Pathology & Laboratory Medicine
Deepti Sachan, Aswin S Kumar
No abstract text is available yet for this article.
July 2016: Asian Journal of Transfusion Science
Ashish Jain, Ajju Agnihotri, Neelam Marwaha, Ratti Ram Sharma
INTRODUCTION: Red cell allo- and auto-immunization is a well recognized problem in multi-transfused thalassemic patients. We conducted this study on 301 multi-transfused thalassemic patients under the Thalassemia Transfusion Programme of Advanced Pediatric Centre of PGIMER. AIMS AND OBJECTIVES: The study was designed to determine the frequency of alloimmunization and autoimmunization in multi-transfused thalassemic patients and to establish the specificity of alloantibody to red cell antigens, if alloimmunization is detected...
July 2016: Asian Journal of Transfusion Science
Jyothis Purushothaman, Kochuthresia J Puthumana, Aswath Kumar, Susheela J Innah, Sareena Gilvaz
Immune thrombocytopenic purpura is a common acquired autoimmune disorder defined by a low platelet count secondary to accelerated platelet destruction or impaired thrombopoesis by anti-platelet antibodies. Thrombopoietin (TPO)-mimetic drugs such as eltrombopag and romiplostim have been used successfully in many nonpregnant individuals with immune thrombocytopenia (ITP) but studies based on its effects in pregnancy are limited. A 27-year-old multigravida who is a known case of ITP with bad obstetric history was referred to the Department of Obstetrics and Gynecology at 26 weeks of gestation with complaints of mucosal bleeding and recurrent abortions...
July 2016: Asian Journal of Transfusion Science
Claudia I Chapuy, Maria D Aguad, Rachel T Nicholson, James P AuBuchon, Claudia S Cohn, Meghan Delaney, Mark K Fung, Meredith Unger, Parul Doshi, Michael F Murphy, Larry J Dumont, Richard M Kaufman
BACKGROUND: Daratumumab (DARA) consistently interferes with routine blood bank serologic testing by directly binding to CD38 expressed on reagent red blood cells (RBCs). Treating RBCs with dithiothreitol (DTT) eliminates the DARA interference. We conducted an international, multicenter, blinded study aimed at validating the DTT method for use by blood bank laboratories worldwide. STUDY DESIGN AND METHODS: Paired plasma sample unknowns were sent to 25 participating blood bank laboratories...
September 7, 2016: Transfusion
Daniela M Borgmann, Sandra Mayr, Helene Polin, Susanne Schaller, Viktoria Dorfer, Lisa Obritzberger, Tanja Endmayr, Christian Gabriel, Stephan M Winkler, Jaroslaw Jacak
In transfusion medicine, the identification of the Rhesus D type is important to prevent anti-D immunisation in Rhesus D negative recipients. In particular, the detection of the very low expressed DEL phenotype is crucial and hence constitutes the bottleneck of standard immunohaematology. The current method of choice, adsorption-elution, does not provide unambiguous results. We have developed a complementary method of high sensitivity that allows reliable identification of D antigen expression. Here, we present a workflow composed of high-resolution fluorescence microscopy, image processing, and machine learning that - for the first time - enables the identification of even small amounts of D antigen on the cellular level...
2016: Scientific Reports
Tik Nga Tong, Emeralda Burke-Murphy, Darinka Sakac, Jacob Pendergrast, Christine Cserti-Gazdewich, Vincent Laroche, Donald R Branch
BACKGROUND: Various versions of the monocyte monolayer assay (MMA) have been used to assess clinical significance of red blood cell (RBC) alloantibodies in transfusion for more than 35 years. However, the optimal conditions, including anticoagulant used for whole blood samples, temperature and duration of storage, and optimal pH for assessing the response of monocytes to antibody-bound RBCs, have never been clearly delineated. STUDY DESIGN AND METHODS: Whole blood from healthy donors was collected in ACD, EDTA, or heparin and stored at room temperature (RT) versus 4°C for up to 2 days...
August 21, 2016: Transfusion
Jose Perdomo
Romiplostim is a thrombopoietin receptor agonist (TPO-RA) used for the treatment of adult primary immune thrombocytopenia (ITP). ITP is an autoimmune condition characterized by low platelet counts due to increased destruction and reduced platelet production. First-line interventions include corticosteroids, anti-D, and intravenous immunoglobulins, while second-line therapies comprise splenectomy, rituximab, cyclosporine A, and TPO-RAs. The recognition that compromised platelet production is a critical part of the pathogenesis of ITP prompted the development of therapeutic strategies based on the stimulation of the TPO receptor...
2016: ImmunoTargets and Therapy
Yoshimi Mizuno, Yuji Shimura, Shigeo Horiike, Tomoko Takimoto, Saori Maegawa, Kazuna Tanba, Yayoi Matsumura-Kimoto, Yukari Sumida, Shotaro Tatekawa, Taku Tsukamoto, Yoshiaki Chinen, Shinsuke Mizutani, Hisao Nagoshi, Mio Yamamoto-Sugitani, Yosuke Matsumoto, Tsutomu Kobayashi, Junya Kuroda, Masafumi Taniwaki
We herein report a rare case of Burkitt lymphoma (BL) preceded by autoimmune hemolytic anemia (AIHA) caused by autoantibodies against D antigen. After a partial response to AIHA with prednisolone (PSL) treatment for 7 months, the patient developed BL with a t(8;22)(q24;q11.2) chromosomal translocation. Intensive immunochemotherapy, including rituximab, led to a complete response (CR) of BL; however, anti-D antibody remained detectable in the plasma and antibody-dissociated solution from erythrocytes, thus continuous therapy with PSL was necessary even after achievement of the CR...
2016: Internal Medicine
Anshu Gupta, Shabnam Mirza, Sarbjeet Khurana, Roopali Singh, Sujata Chaturvedi, Bharat Singh
INTRODUCTION: The Rh blood group system is one of the most polymorphic and immunogenic blood group systems in humans. The expression of Rh blood group antigen is complex, among that Rh-D antigen is the most important antigen because of its immunogenicity. It is easy to detect D antigen in most of the cases. Sometimes, variable expression of Rh-D antigen leads to presence of weak forms. Weak D reacts variably with anti D sera and poses a problem in blood banking. Molecular genetics of Rh-D revealed that weak D antigen is a Rh-D phenotype that possesses less numbers of complete D antigens on the surface of red blood cells...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
Mariela Granero Farias, Suzane Dal Bó, Simone Martins de Castro, Aline Reis da Silva, Joyce Bonazzoni, Luciana Scotti, Sergio H Almeida Martins Costa
Accurate detection and quantitation of fetomaternal hemorrhage (FMH) is critical to the obstetric management of rhesus D alloimmunization in Rh-negative pregnant women. The flow cytometry is based on the detection of fetal red blood cells using a monoclonal anti-HbF antibody, and is the method most indicated for this estimation. The objective of this study was to quantify fetal red blood cell levels of pregnant women using flow cytometry. We analyzed 101 peripheral blood samples from Rh-negative and Rh-positive women, whose mean age was 24 years (20-32 years), after vaginal delivery or cesarean section...
August 5, 2016: Fetal and Pediatric Pathology
Lani Lieberman, Jordan Spradbrow, Amy Keir, Michael Dunn, Yulia Lin, Jeannie Callum
BACKGROUND: Intravenous immunoglobulin (IVIG) is used to treat a variety of diseases in the neonatal intensive care unit (NICU). Although audits have reported on the spectrum of IVIG use in adults, the indications and utilization in neonates has not been investigated. The objectives of this study were to describe the usage pattern of and indications for IVIG in a tertiary care NICU. STUDY DESIGN AND METHODS: A retrospective chart review was performed of all neonates who received IVIG in the NICU from January 2003 to December 2013...
July 26, 2016: Transfusion
L L Golovkina, A G Stremoukhova, T D Pushkina, R S Kalandarov, G V Atroshchenko, M N Vasil'eva, V L Surin, V V Salomashkina, O S Pshenichnikova, G Yu Miterev, E N Parovichnikova, V G Savchenko
AIM: to estimate the spread of weak D antigen types of the Rhesus system in the citizens of the Russian Federation and a possibility of serologically identifying these types. SUBJECTS AND METHODS: The red blood cells and DNA of people with weakened expression of D antigen were investigated using erythrocyte agglutination reaction in salt medium (2 methods); agglutination reaction in the gel columns containing IgM + IgG anti-D antibodies, indirect antiglobulin test with IgG anti-D antibodies (2 methods); polymerase chain reaction to establish the type of weak D...
2016: Terapevticheskiĭ Arkhiv
Meena Sidhu, Renu Bala, Naveen Akhtar, Vijay Sawhney
Screening and detection of clinically significant antibodies among antenatal women plays an important role in transfusion safety and preventing hemolytic disease of fetus and newborn. Routine screening of antenatal women for antibodies is not done in all blood centres of our country and so immunization rates are not known in pregnant women. We studied the prevalence of alloantibodies and titration of Anti D among antenatal multiparous women in Jammu region. In present prospective study, 750 antenatal multiparous women attending antenatal clinics were typed for ABO and D antigens...
September 2016: Indian Journal of Hematology & Blood Transfusion
Alexandre Vivanti, Alexandra Benachi, François-Xavier Huchet, Yves Ville, Henri Cohen, Jean-Marc Costa
BACKGROUND: Rhesus D genotyping using cell-free fetal DNA is currently used throughout the world. While this technique has spread rapidly, its optimal use is still a matter of debate. This screening test has mainly been introduced for managing RhD-negative pregnant women during the third trimester of pregnancy, thereby avoiding systematic anti-D prophylaxis, yet such a strategy has proven cost-ineffective. Publications reporting on fetal RHD genotyping using cell-free DNA in maternal plasma, specifically during the first trimester of pregnancy, are scarce in the scientific literature...
July 5, 2016: American Journal of Obstetrics and Gynecology
Genghis H Lopez, Eunike C McGowan, Kelli A McGrath, Maria E Abaca-Cleopas, Elizna M Schoeman, Glenda M Millard, Helen O'Brien, Yew-Wah Liew, Robert L Flower, Catherine A Hyland
BACKGROUND: Blood donors whose red blood cells (RBCs) exhibit a partial RhD phenotype, lacking some D epitopes, present as D+ in routine screening. Such phenotypes can exhibit low-frequency antigens (LFAs) of clinical significance. The aim of this study was to describe the serologic and genetic profile for a blood donor with an apparent D+ phenotype carrying a variant RHD gene where D Exons 5 and 6 are replaced by RHCE Exon (5-6). STUDY DESIGN AND METHODS: Anti-D monoclonal antibodies were used to characterize the presentation of RhD epitopes on the RBCs...
September 2016: Transfusion
Abeer Mohamed Abdelrazik, Shahira Morsy Elshafie, Manal Niazi El Said, Ghada M Ezzat Ahmed, Al-Kassem Ahmed Al-Gamil, Mona Gamal Mostafa El Nahhas, Ahmed Ali Badie Sady
BACKGROUND: β-Thalassemia is considered the most common chronic hemolytic anemia in Egypt. Alloimmunization can lead to serious clinical complications in transfusion-dependent patients. The objective of this study was to determine the frequency and types of alloantibodies, and, in addition, to study the risk factors that might influence alloimmunization in multiply transfused thalassemia patients in Fayoum, Egypt, with the goal that this study could help minimize some of the transfusion-associated risks in those patients...
September 2016: Transfusion
Lidice Bernardo, Alaa Amash, Danielle Marjoram, Alan H Lazarus
Although the prevention of hemolytic disease of the fetus and newborn is highly effective using polyclonal anti-D, a recombinant alternative is long overdue. Unfortunately, anti-D monoclonal antibodies have been, at best, disappointing. To determine the primary attribute defining an optimal antibody, we assessed suppression of murine red blood cell (RBC) immunization by single-monoclonal antibodies vs defined blends of subtype-matched antibodies. Allogeneic RBCs expressing the HOD antigen (hen egg lysozyme [HEL]-ovalbumin-human transmembrane Duffy(b)) were transfused into naïve mice alone or together with selected combinations of HEL-specific antibodies, and the resulting suppressive effect was assessed by evaluating the antibody response...
August 25, 2016: Blood
A Gielezynska, A Stachurska, J Fabijanska-Mitek, M Debska, K Muzyka, E Kraszewska
INTRODUCTION: In various countries, standard doses of anti-D IgG used for postpartum immunoprophylaxis of hemolytic disease of fetus and newborn (HDFN) vary from 100 μg to 300 μg. There are also different regulations concerning FMH assessment, and opinions about applicable tests are inconclusive. METHODS: Three flow cytometry tests (FCTs) with anti-D, anti-HbF, anti-HbF+CA antibodies, and two modifications of microscopic Kleihauer-Betke test (KBT) were used. RESULTS: In all artificial mixtures with known concentrations, FCTs and KBT with counting 10 000 RBCs had similar satisfying sensitivity and specificity...
August 2016: International Journal of Laboratory Hematology
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