Red cell autoimmunization and alloimmunization in myelodysplastic syndromes: prevalence, characteristic and significance

Chhetri, Rakchha; Wee, Li Yan A.; Sinha, R. K.; Kutyna, Monika M; Pham, Anh; Stathopoulos, Helen; Nath, Lakshmi; Nath, Shriram V.; Wickham, Nicholas; Hughes, Toby; Singhal, Deepak; Roxby, David; Hiwase, Devendra

doi:10.3324/haematol.2018.215087

Cited by 16 publications

(19 citation statements)

References 14 publications

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“…We are not aware of published studies comparing rates of immune‐mediated PLT‐R in MDS with other hematologic malignancy. However, we and others have previously reported high rates of RBC alloimmunization in MDS 15–17 . It is possible that MDS has a particular propensity to be associated with the development of immune‐mediated hemopoietic cell destruction.…”

Section: Discussionmentioning

confidence: 77%

“…However, we and others have previously reported high rates of RBC alloimmunization in MDS. [15][16][17] It is possible that MDS has a particular propensity to be associated with the development of immune-mediated hemopoietic cell destruction. These data taken together suggest that MDS patients and more specifically female MDS patients are at high risk of HLA alloimmunization.…”

Section: Discussionmentioning

confidence: 99%

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The burden of immune‐mediated refractoriness to platelet transfusions in myelodysplastic syndromes

et al. 2020

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Background Up to 65% of patients with myelodysplastic syndromes (MDS) have thrombocytopenia and require platelet (PLT) transfusion. The current standard of practice is to provide random-or single-donor PLT transfusion and manage PLT refractoriness (PLT-R) if and when it develops. This study assessed the prevalence and risk factors for immune-mediated PLT-R in patients in the South Australian (SA) MDS Registry. Study Design and Methods: A retrospective analysis of MDS patients enrolled in the SA-MDS registry was performed. HLA data was analyzed from January 2003 to 30 June 2017 to ensure minimum follow-up of 2 years. Results: During the study period, 341 of 681 (50%) MDS patients required at least one PLT transfusion, with 29 of 341 (9%) of all PLT transfusion patients requiring HLA-matched PLT transfusion for PLT-R. Of these 29 patients, 70% were females treated with disease-modifying therapies suggesting that these patients are at high risk of HLA alloimmunization. Conclusions: Immune-mediated PLT-R is common in MDS and can be expensive and difficult to manage once it occurs. Therefore, PLT transfusion prac

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

The burden of immune‐mediated refractoriness to platelet transfusions in myelodysplastic syndromes

et al. 2020

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“…Chee et al 43 "survival was not affected by the total number of RBC transfusions received (…) the results of the current study also suggest limited morbidity from iron overload in patients with RARS." Chettri et al 38 "RBC alloimmunization increases RBC transfusion requirements in patients with single and multiple alloantibodies. "…”

Section: Survivalmentioning

confidence: 99%

“…12,32 Sixteen studies reported on non-iron overload related complications of transfusions in MDS patients. 8,9,11,15,17,[20][21][22][23]25,27,28,[34][35][36]38 One case series of MDS patients found transfusion-dependence prior to stem cell transplantation to be an independent risk factor for graftversus-host disease. 8 One study found that RBC transfusion was associated with reduced coagulability and endothelial glycocalyx degradation.…”

Section: Clinical Complicationsmentioning

confidence: 99%

“…22 Eight studies reported on rates of RBC alloimmunization and/or autoimmunization in transfused MDS patients, with rates of alloimmunization ranging from 4.5% to 55%. 9,17,20,21,23,25,34,36,38 Two reports focused on adverse transfusion reactions in the MDS population, with febrile non-haemolytic transfusion reactions making up 46%…”

Section: Clinical Complicationsmentioning

confidence: 99%

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Red blood cell transfusion in myelodysplastic syndromes: A systematic review

Kaka

Jahangirnia

Beauregard

et al. 2021

Transfusion Medicine

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Patients with myelodysplastic syndrome (MDS) frequently receive red blood cell (RBC) transfusions for anaemia resulting from ineffective erythropoiesis. While RBC transfusions may rapidly increase haemoglobin values, their impact on clinical and health services outcomes in MDS patients has not previously been summarized. We conducted a systematic review of the literature to evaluate risks and benefits of RBC transfusions in MDS patients. We searched electronic databases (MEDLINE, Embase, CENTRAL, CINAHL) from inception through June 4, 2021 to identify studies reporting data on RBC transfusions in MDS patients. Full text publications that assessed RBC transfusions as an intervention and reported at least one clinical, laboratory, or healthcare outcome associated with transfusion were included. Study characteristics, transfusion information and transfusion-related outcomes were extracted and reported. We identified 1243 original studies, of which 38 met eligibility requirements and were included.Fourteen reported on survival following diagnosis of MDS, with the majority reporting poorer survival among patients receiving or requiring more frequent transfusions. Nine reported on transfusion-related iron overload and its complications. Other outcomes included rates of allo/autoimmunization and adverse transfusion reactions, and healthcare costs incurred by patients with a greater transfusion burden. Only two studies reported on symptom relief following transfusion. This review underscores transfusion dependence as a negative prognostic factor for MDS patients and highlights the paucity of evidence surrounding quality of life and symptom-related outcomes following RBC transfusions in this population. Further study of patient-important outcomes associated with transfusion in MDS patients is warranted to improve therapeutic recommendations and inform resource allocation.

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Pretransplantation Red Blood Cell and Platelet Transfusion Burden in De Novo Myelodysplastic Syndrome Undergoing Allogeneic Transplantation

Konuma

Aoki²,

Ozawa³

et al. 2021

Transplantation and Cellular Therapy

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Red cell autoimmunization and alloimmunization in myelodysplastic syndromes: prevalence, characteristic and significance

Cited by 16 publications

References 14 publications

The burden of immune‐mediated refractoriness to platelet transfusions in myelodysplastic syndromes

The burden of immune‐mediated refractoriness to platelet transfusions in myelodysplastic syndromes

Red blood cell transfusion in myelodysplastic syndromes: A systematic review

Pretransplantation Red Blood Cell and Platelet Transfusion Burden in De Novo Myelodysplastic Syndrome Undergoing Allogeneic Transplantation

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