Multiple red cell antigen loss in acute granulocytic leukemia

Abstract

Loss of certain red blood cell antigens has been described in various disease states including acute granulocytic leukemia (AGL). This paper describes the loss of blood group A antigen in three patients, two with AGL and a third with a myeloproliferative disorder similar to AGL which developed following total body irradiation for malignant, well-differentiated lymphocytic lymphoma. In the latter case, the onset of the myeloproliferative disease correlated with the loss of A antigen. In addition to A antigen loss, all three patients' red cells showed the loss of Lewisb antigen, a finding previously unreported. Finally, the two patients with AGL also exhibited the loss of I antigen from their red cells. The loss can be transient and the reappearance of the A antigen has been correlated with remission of leukemia." However, Hoogstraten et al. l3 described a patient who developed leukemia and lost the A antigen only to regroup as an Al during the terminal relapse following an induced remission. In addition to the A antigen, investigators have described changes in B and H antigens of the ABO sysgens which, like the ABO system, are considered to be stable throughout life. These include the D and E antigens of the Rh sys-M and N antigens of the MNSsU s y~t e r n '~*~~; Lea of the Lewis system"; and Ii of the I blood group ~y s t e r n . ' ,~~'~.~~~~~ tem,17.31.32 p lu s other blood group system antiFrom the Blood Bank

ABO, H, and Lewis Systems

“…Between 17% and 37% of patients with leukaemia have signifi cantly lower A, B, or H antigenic expression compared with healthy controls [504 -507] . Loss of an ABH antigen in a patient with a haematological disorder is generally prognostic of AML [509] . In almost all cases the changes represent a loss or diminution of antigen strength and not the expression of a new red cell antigen, although one case is reported of a group O ( O 1v /O 1v ) patient with myelodysplastic syndrome acquiring an A antigen [261] .…”

“…Acute leukaemia has, on occasion, been associated with loss or weakening of Lewis antigens [499,509,511] .…”

Inference about Misclassification Probabilities from Repeated Binary Responses

“…False-positive and false-negative errors may be influenced by various factors. It has been reported that aging (Danon and Marikovsky, 1988;Saphire et al, 1993) and certain malignant hematopoetic diseases, like leukemia (Kolins, Holland, and McGinniss, 1978;Atkinson, Tanley, and Wallas, 1987), may cause loss of antigen-surface response in the ABO blood group. This reduced expression of antigen may lead to falsenegative error.…”

ABO genotyping in leukemia patients reveals new ABO variant alleles

“…Aberrant expression of ABO antigens has been reported in pre-malignant and in malignant cells. The weakness of ABO antigens in leukemia patients has been reported mainly by serological analysis in individual case reports, especially in the myeloid lineage, or in small numbers of samples (Kolins et al, 1978;Matsuki et al, 1992).…”