Importance of extended blood group genotyping in multiply transfused patients

Osman, Nadila Haryani; Sathar, Jameela; Leong, Chooi Fun; Zulkifli, Noor Fadzilah; Sabudin, Raja Zahratul Azma Raja; Ainoon, O; Asnawi, Asral Wirda Ahmad

doi:10.1016/j.transci.2017.03.009

Cited by 15 publications

(15 citation statements)

References 31 publications

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“…Notably, no significant differences observed in the results of both methods except for Kpb antigen in group 1 patients. These results were similar to the results of other studies among blood donors and healthy volunteers [ 9 , 15 ]. Our results together with others indicate no superiority of genotyping over phenotyping when used to identify blood group typing for subjects with no history of prior transfusion and negative screening antibody test.…”

Section: Discussionsupporting

confidence: 92%

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Genotyping versus phenotyping of non-ABO erythrocyte antigens in patients with the Mediterranean hemopathic syndromes: Effect of transfusion therapy

et al. 2021

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The Mediterranean hemopathic syndromes (MHS) are the most prevalent hemoglobinopathies in the Mediterranean basin. Transfusion therapy is the main therapy for these disorders, particularly for severe forms of the disease. Currently, pre-transfusion serological typing of erythrocyte antigens is the standard tool for reducing complications of transfusion in those patients. This study compared genotyping with phenotyping of non-ABO erythrocyte antigens in patients with MHS and assessed the effect of transfusion therapy on their results. One-hundred ninety-eight MHS patients were recruited, screened, and proven negative for allo-antibodies. They were grouped into two groups: (1) 20 newly diagnosed patients with no transfusion history and (2) 178 previously diagnosed patients undergoing transfusion therapy. Patients were interviewed and clinically examined. Full blood count (FBC) and high performance liquid chromatography (HPLC) were done for group 1 only. Genotyping and phenotyping of non-ABO erythrocyte antigens were performed for group 1, and 25 patients out of group 2 were propensity score-matched (PSM) with group 1. Both groups were gender and age matched; 55% and 74% of groups 1 and 2 had major disease, respectively. Insignificant differences were observed between genotyping and phenotyping of non-ABO erythrocyte antigens in group 1, while significant discrepancies and mixed field results were noted in group 2 patients. Discrepancies were obvious with JKa, JKb, and little c antigens. Conclusively, molecular typing is a powerful tool for pre-transfusion testing in chronically transfused MHS patients. This testing reduces incidence of transfusion reactions. JKa, JKb and little c antigens are the most clinically significant non-ABO erythrocyte antigens.

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Section: Discussionsupporting

confidence: 92%

“…This generates difficulties in accurate phenotyping of patient’s blood. Thus may upsurge the risk of alloimmunization as some of these blood group antigens can stimulate clinically significant antibodies and cause transfusion reactions [ 9 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Genotyping versus phenotyping of non-ABO erythrocyte antigens in patients with the Mediterranean hemopathic syndromes: Effect of transfusion therapy

et al. 2021

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“…In a study from the USA, of the 16 patients studied, four (one SCD patient and three thalassaemics) demonstrated multiple antigen (M, c, E, K, Jk a and Jk b ) discrepancies21. Among 200 thalassaemic patients studied, 71 per cent discrepancy between phenotype and genotype was reported in Duffy system, 38.5 per cent in Kidd system and 53.5 per cent cases in the Rh blood group system which was comparable for Duffy and Rh but lower for Kidd antigens in a Malaysian study22. Our findings also showed higher total discrepancy rate (77%), although the results were not directly compared with others due to different ethnic background, variable sample size, different age group and difference in RBC units transfused.…”

Section: Discussionmentioning

confidence: 73%

Molecular genotyping of clinically important blood group antigens in patients with thalassaemia

Kulkarni¹,

Choudhary²,

Gogri³

et al. 2018

Indian Journal of Medical Research

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Background & objectives: In multitransfused thalassaemic patients, haemagglutination fails to phenotype the patient's blood group antigens due to the presence of donor-derived erythrocytes. DNA-based methods can overcome the limitations of haemagglutination and can be used to determine the correct antigen profile of these patients. This will facilitate the procurement of antigen-matched blood for transfusion to multitransfused patients. Thus, the aim of this study was to compare the serological phenotyping of common and clinically important antigens of Rh, Duffy, Kell, Kidd and MNS blood group systems with molecular genotyping amongst multitransfused thalassaemic patients. Methods: Blood samples from 200 patients with thalassaemia and 100 ‘O’ group regular blood donors were tested using standard serological techniques and polymerase chain reaction-based methods for common antigens/alleles (C, c, D, E, e, Fy a , Fy b , Jk a , Jk b , K, k, M, N, S, s). Results: Genotyping and phenotyping results were discordant in 77 per cent of thalassaemic patients for five pairs of antithetical antigens of Rh, Duffy, Kell and Kidd blood group systems. In the MNS blood group system, 59.1 per cent of patients showed discrepancy. The rate of alloimmunization among thalassaemics was 7.5 per cent. Interpretation & conclusions: Molecular genotyping enabled the determination of the actual antigen profile in multitransfused thalassaemia patients. This would help reduce the problem of alloimmunization in such patients and would also aid in the better management of transfusion therapy.

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“…Alloimmunization also triggers additional alloantibodies and autoantibody formation and can increasingly complicate further transfusion in these patients (Matteocci & Pierelli, 2014 ; Yazdanbakhsh et al, 2012 ). Accordingly, accurate RBC antigen profiling is important in thalassemia patients to reduce the risk of exposure to foreign RBC antigens and decrease the occurrence of alloimmunization (Osman et al, 2017 ). Serological phenotyping based on hemagglutination is a conventional method used to determine blood group antigens (Monteiro et al, 2011 ).…”

Section: Introductionmentioning

confidence: 99%

“…However, this method has many limitations, especially in patients with chronic or recent transfusions due to the presence of circulating transfused RBCs and interfering allo‐ or autoantibodies (Belsito et al, 2017 ; Fasano & Chou, 2016 ). Understanding the molecular background of blood groups can lead to solving the problems associated with serological methods and can predict blood group antigens by testing DNA with a high degree of accuracy (Belsito et al, 2015 ; Osman et al, 2017 ). Molecular assays are not influenced by the presence of immunoglobulins, transfused cells, or the limitations commonly found with the antisera and can be used to determine RBC antigens even in recently transfused patients or those receiving multiple blood transfusions (Fasano & Chou, 2016 ; Osman et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Blood group genotyping in alloimmunized multi‐transfused thalassemia patients from Iran

Sarihi

Oodi

tehrani

et al. 2021

Molec Gen & Gen Med

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Objectives Serological methods may not be reliable for RBC antigen typing, especially in multi‐transfused patients. The blood group systems provoking the most severe transfusion reactions are mainly Rh, Kell, Kidd, and Duffy. We intended to determine the genotype of these blood group system antigens among Iranian alloimmunized thalassemia patients using molecular methods and compare the results with serological phenotyping. Methods Two hundred patients participated in this study. Blood group phenotype and genotype were determined using the serological method and PCR‐SSP, respectively. The genotypes of patients with incompatibility between phenotype and genotype were re‐evaluated by RFLP‐PCR and confirmed by DNA sequencing. Results Discrepancies between phenotype and genotype results were found in 132 alleles and 83 (41.5%) patients; however, there was complete accordance between the three genotyping methods. Most discrepancies were detected in Rh and Duffy systems with 47 and 45 cases, respectively, and the main discrepancy was in the FY*B/FY*B allele when serologically showed Fy(a+b+). All 39 undetermined phenotypes, due to mixed‐field reactions, were resolved by molecular genotyping. Conclusion Molecular genotyping is more reliable compared with the serological method, especially in multi‐transfused patients. Therefore, the addition of blood group genotyping to serological assays can lead to an antigen‐matched transfusion in these patients.

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Importance of extended blood group genotyping in multiply transfused patients

Cited by 15 publications

References 31 publications

Genotyping versus phenotyping of non-ABO erythrocyte antigens in patients with the Mediterranean hemopathic syndromes: Effect of transfusion therapy

Genotyping versus phenotyping of non-ABO erythrocyte antigens in patients with the Mediterranean hemopathic syndromes: Effect of transfusion therapy

Molecular genotyping of clinically important blood group antigens in patients with thalassaemia

Blood group genotyping in alloimmunized multi‐transfused thalassemia patients from Iran

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