title: Increased Incidence of Red Blood Cell Alloantibodies in Myelodysplastic Syndrome.
abstract: BACKGROUND
  Approximately 80% of patients with myelodysplastic syndromes (MDS) receive multiple red blood cells (RBC), often multiple transfusions, and are therefore prone to develop alloantibodies against RBC. Because of increasing evidence for the role of immune dysregulation in the pathobiology of MDS, we hypothesized that in patients with MDS there is an increase in alloantibody formation beyond that expected from multiple transfusions.
  
  
  OBJECTIVE
  To determine the prevalence rates of alloantibodies in patients with MDS who are transfusion dependent and compare them to rates of non-MDS patients matched for number of RBC units they received.
  
  
  METHODS
  The blood bank database was screened to identify non-MDS patients matched for age and number of units transfused. Logistic regression analysis was applied to determine factors affecting alloantibody formation.
  
  
  RESULTS
  Of 60 patients with MDS, 18 (30%) developed alloantibodies against RBC. Transfusion-dependent MDS and non-MDS patients (N = 56 each), matched for number of RBC units and age, were compared. Fifteen MDS patients (27%) but only 12 non-MDS patients (12%) developed alloantibodies (P = 0.057). The relative risk for developing antibodies in MDS patients was 2.14, and MDS was the strongest predictor for formation of alloantibodies during transfusion therapy (odds ratio 3.66, confidence interval 1.4-9.3).
  
  
  CONCLUSIONS
  Patients with MDS are at increased risk to develop RBC alloantibodies, partly because these patients receive multiple RBC transfusions. Whether matching for RH and KEL would lead to lower rates of RBC alloantibodies remains to be determined.
authors.forename: Uri
authors.initials: U
authors.lastname: Rozovski
authors.forename: Ofira
authors.initials: O
authors.lastname: Ben-Tal
authors.forename: Ilya
authors.initials: I
authors.lastname: Kirgner
authors.forename: Moshe
authors.initials: M
authors.lastname: Mittelman
authors.forename: Mara
authors.initials: M
authors.lastname: Hareuveni
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017707:Erythrocyte Transfusion; D004912:Erythrocytes / Q000276:immunology*; D005260:Female; D006801:Humans; D015994:Incidence; D007518:Isoantibodies / Q000276:immunology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000276:immunology*; D015995:Prevalence; D012189:Retrospective Studies
chemical_list: D007518:Isoantibodies