The prevalence of immunization to Duffy antigens in a population of known racial distribution

Abstract

A retrospective study at our hospital determined the race or ethnicity of patients seen in an 8-year period who had formed antibodies to Duffy antigens. During that time, 9876 serologic investigations had been performed as a result of a positive direct or indirect antiglobulin test. Among these samples, sera from 45 previously transfused or pregnant patients contained anti-Fya and two contained anti-Fy3. Twenty-nine of the sera that contained anti-Fya (62%) were from blacks, 12 (25%) were from whites, and 6 (13%) were from Hispanics. Both examples of anti-Fy3 were made by black patients. Red cells (RBCs) from 21 of the black patients were Fy(a-b-), those from 7 were Fy(a-b+), and those from 1 could not be phenotyped. RBCs from 17 of the non-black patients were Fy(a-b+) and those from 1 could not be phenotyped. The population of transfused patients evaluated in this study was 47 percent black, 29 percent white, and 24 percent Hispanic. Calculations based on an expected Fy(a-) frequency of 88 percent in blacks, 33 percent in whites, and 20 percent in Hispanics predict that the racial makeup of the Fy(a-) population at our hospital would be 73 percent black, 18 percent white, and 9 percent Hispanic, which is not significantly different (p = 0.25) from the racial makeup of the patients forming anti-Fya and -Fy3. These data indicate that blacks make antibodies to Duffy antigens as frequently as non-blacks.

Problems of chronic transfusion in sickle cell disease

“…antibodies as frequently as whites [29], and as stated earlier, SCD patients seem to form C, E, Fy", Jkb, and S antibodies more readily than other blacks and whites [9]. The review summarized in Table I1 corroborates these observations.…”

Mutations in the erythrocyte chemokine receptor (Duffy) gene: the molecular basis of the Fya/Fyb antigens and identification of a deletion in the Duffy gene of an apparently healthy individual with the Fy(a – b–) phenotype

“…It is possible that very small amounts of Duffy GP are expressed on the erythrocytes of these individuals and/or Duffy GP is expressed normally in other tissues. A comparative study carried out in the United States showed that African-Americans (68% of whom were Fy(ab-)) make anti-Fya with the same frequency as Americans of European origin (Sosler et al, 1989). Antibodies to Fyb antigen were not found in either group.…”

A simple, practical model for reducing alloimmunization in patients with sickle cell disease

“…Although it was originally suggested that blacks do not form antibodies to Duffy antigens as frequently as nonblacks [13], we have shown the opposite to be true, that is, blacks form Duffy antibodies more frequently than non-blacks [14]. In this study we retrospecitvely identified 47 patients sera over an 8 year period whose sera demonstrated antibodies to Duffy antigens.…”