title: Molecular matching for Rh and K reduces red blood cell alloimmunisation in patients with myelodysplastic syndrome.
abstract: BACKGROUND
  Matching for Rh and K antigens has been used in an attempt to reduce antibody formation in patients receiving chronic transfusions but an extended phenotype matching including Fy(a) and Jk(a) antigens has also been recommended. The aim of this study was to identify an efficient transfusion protocol of genotype matching for patients with myelodysplastic syndrome (MDS) or chronic myelomonocytic leukaemia. We also examined a possible association of HLA class II alleles with red blood cell (RBC) alloimmunisation.
  
  
  METHODS
  We evaluated 43 patients with MDS undergoing transfusion therapy with and without antibody formation. We investigated antigen-matched RBC units for ABO, D, C, c, E, e, K, Fy(a), Fy(b), Jk(a), Jk(b), S, s, Do(a), Do(b) and Di(a) on the patients' samples and on the donor units serologically matched for them based on their ABO, Rh and K phenotypes and presence of antibodies. We also determined the frequencies of HLA-DRB1 alleles in the alloimmunised and non-alloimmunised patients.
  
  
  RESULTS
  Seventeen of the 43 patients had discrepancies or mismatches for multiple antigens between their genotype-predicted profile and the antigen profile of the units of blood serologically matched for them. We verified that 36.8% of patients had more than one RBC alloantibody and 10.5% of patients had autoantibodies. Although we were able to find a better match for the patients in our extended genotyped/phenotyped units, we verified that matching for Rh and K would be sufficient for most of the patients. We also observed an over-representation of the HLA-DRB1*13 allele in the non-alloimmunised group of patients with MDS.
  
  
  CONCLUSIONS
  In our population molecular matching for C, c, E, e, K was able to reduce RBC alloimmunisation in MDS patients. An association of HLA-DRB1*13 and protection from RBC alloimmunisation should be confirmed.
authors: Hemocentro-UNICAMP, Campinas State University, Campinas, Sao Paulo, Brazil.
authors: Gláucia A S
authors: GA
authors: Guelsin
authors: Basic Health Sciences Department, Maringa State University, Maringa, Parana, Brazil.
authors: Camila
authors: C
authors: Rodrigues
authors: Basic Health Sciences Department, Maringa State University, Maringa, Parana, Brazil.
authors: Jeane E L
authors: JE
authors: Visentainer
authors: Hemocentro-UNICAMP, Campinas State University, Campinas, Sao Paulo, Brazil.
authors: Paula
authors: P
authors: De Melo Campos
authors: Hemocentro-UNICAMP, Campinas State University, Campinas, Sao Paulo, Brazil.
authors: Fabíola
authors: F
authors: Traina
authors: Hemocentro-UNICAMP, Campinas State University, Campinas, Sao Paulo, Brazil.
authors: Simone C O
authors: SC
authors: Gilli
authors: Hemocentro-UNICAMP, Campinas State University, Campinas, Sao Paulo, Brazil.
authors: Sara T O
authors: ST
authors: Saad
authors: Hemocentro-UNICAMP, Campinas State University, Campinas, Sao Paulo, Brazil.
authors: Lilian
authors: L
authors: Castilho
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001787:Blood Group Incompatibility / Q000097:blood / Q000235:genetics / Q000517:prevention & control; D001788:Blood Grouping and Crossmatching / Q000379:methods*; D001803:Blood Transfusion; D005260:Female; D060005:Genotyping Techniques; D059811:HLA-DRB1 Chains / Q000097:blood / Q000235:genetics; D006801:Humans; D007518:Isoantibodies / Q000097:blood; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000097:blood / Q000235:genetics / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000235:genetics / Q000628:therapy; D012204:Rh-Hr Blood-Group System / Q000097:blood / Q000235:genetics
chemical_list: D059811:HLA-DRB1 Chains; C506473:HLA-DRB1*13 antigen; D007518:Isoantibodies; D012204:Rh-Hr Blood-Group System