ABO discrepancy in pediatric lymphomas and solid organ tumors.

Abstract

Objective: To determine the frequency of ABO discrepancies in pediatric patients of lymphoma and solid organ tumors and to categorize these discrepancies and their resolution. Study Design: Cross-sectional study. Setting: Department of Hematology & Transfusion Medicine, The University of Child Health Sciences & The Children’s Hospital, Lahore. Period: November 2020 to September 2021. Material & Methods: ABO blood group discrepancies were assessed by tube method of blood grouping, using antisera A, B, AB & D for forward grouping and A, B, and O cells for reverse grouping. Auto control was also run. The resolution techniques were used accordingly. The collected data was checked for its completeness, consistency and accuracy before analysis which was done on SPSS version 26. Results: In this study, a total of 105 subjects were included with mean age of 5.64 ±2.1 years. Among them 72(68.6%) were male and 33(31.4%) were female. Out of total samples processed, three (2.9%) discrepancies found, 1 in female and 2 in male patients. There were two cases of Group I ABO discrepancies, one of which was resolved by elution, antibody screening and identification and other by incubation at 37oC and correlation with previous transfusion history. One case of Group II ABO discrepancy which was resolved by incubation at 40C for 30 minutes. Conclusion: This shows that ABO discrepancies occur in pediatric patients of lymphoma and solid organ tumors. So, the interpretation of forward and reverse ABO blood grouping, identification and resolution of ABO discrepancies in these patients should be done very carefully to avoid any transfusion related adverse reactions.

Prevalence of A2 and A2B Subgroups among Blood Groups A and AB in healthy donors

“…In routine testing, both A1 and A2 are strongly agglutinated by anti-A antiserum but problem arises when A2 blood group individuals develop anti-A1 antibody which can cause discrepancies in blood grouping. 5 …”

“…In routine testing, both A1 and A2 are strongly agglutinated by anti-A antiserum but problem arises when A2 blood group individuals develop anti-A1 antibody which can cause discrepancies in blood grouping. 5 When anti-A1 is active at body temperature, though rare, extensive destruction of A1 cells in vivo can occur and has been documented to cause severe hemolytic transfusion reaction. It is also important in cases of organ transplant.…”

Resolving discrepancies in forward and reverse ABO blood group typing

“…Group I represents missing antibodies, group II is associated with unpredicted reaction due to weak antigens, group III demonstrates rouleaux formation and pseudo-aggluti-nation, group IV is associated with autoantibodies and polyagglutination. 2,3 In haematological malignancies and epigenetic variations of group A and B transferases the erythrocyte antigen genes expression might be lost. 4 Tumour cells were reported to secrete serum soluble blood group substances.…”