Blood donors with positive direct antiglobulin tests are at increased risk for cancer

Abstract

There is evidence of a significantly increased risk of cancer, especially hematologic malignancies, among blood donors with a positive DAT even within a short follow-up period.

A healthy donor or unsuspecting patient

“…At this time, we would not include the observation by Rottenberg and colleagues in our notification letter, but given the opportunity, would share its findings—in context—with the donor's physician. This program is consistent with the assessment by Rottenberg and colleagues that further studies are necessary to confirm this association 3 and with our approach; that is, a level of personal interaction with the donor is necessary to provide information that stimulates the donor to seek evaluation and the donor's physician to do the appropriate management, but not to stimulate premature and unnecessary anxiety.…”

“…In this issue of TRANSFUSION , Rottenberg and colleagues report an increased risk of cancer, especially hematologic malignancies, in blood donors with positive direct antiglobulin tests (DATs) 3 . They report that DAT‐positive donors are notified by letter and referred to their family physician for further medical counseling and follow‐up.…”

The direct antiglobulin test: A critical step in the evaluation of hemolysis

“…Normal A positive DAT can be found in 1 in 1,000-1:14,000 healthy blood donors without hemolysis [6,7]. The significance of this finding is unclear, but some individuals may go on to develop autoimmune hemolytic anemia (AIHA) or cancer [8,9]. The DAT is positive in 7-8% of hospitalized patients and up to 15% of hospitalized patient specimens [10 and references therein].…”

Autoimmune Haemolytic Anaemia in Patients with Cancer Diagnoses

“…More than half the cases of AIHA are warm AIHA with an incidence of 1/50,000 -80,000 persons [3,4]. About 1 in 1,000 -36,000 healthy blood donors may have a positive DAT result [5]. AIHA can be broadly grouped into two: primary (or Idiopathic) and secondary, based on the presence or absence of an underlying disease.…”

“…Serologically detectable warm-reactive autoantibodies do not always result in haemolysis. Majority of patients with AIHA have an associated primary clinical condition and the strength of the DAT reactivity for IgG and C3 correlates with the presence or absence of haemolysis [5].…”