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Br J Haematol. 2015 Jul;170(2):247-56. doi: 10.1111/bjh.13424. Epub 2015 Apr 19.

Red blood cell transfusions are associated with HLA class I but not H-Y alloantibodies in children with sickle cell disease.

Author information

1
Aflac Cancer and Blood Disorders Centre, Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA.
2
Department of Pathology, Emory University, Atlanta, GA, USA.
3
Departments of Laboratory Medicine and Paediatrics, Yale University, New Haven, CT, USA.
4
Ben Towne Centre for Childhood Cancer Research, Seattle Children's Research Institute, Department of Paediatrics, University of Washington, Fred Hutchinson Cancer Research Centre, Seattle, WA, USA.
5
Division of Blood and Marrow Transplantation, Stanford University, Stanford, CA, USA.

Abstract

Blood transfusions can induce alloantibodies to antigens on red blood cells (RBCs), white blood cells and platelets, with these alloantibodies affecting transfusion and transplantation. While transfusion-related alloimmunization against RBC antigens and human leucocyte antigens (HLA) have been studied, transfusion-related alloimmunization to minor histocompatibility antigens (mHA), such as H-Y antigens, has not been clinically characterized. We conducted a cross-sectional study of 114 children with sickle cell disease (SCD) and tested for antibodies to 5 H-Y antigens and to HLA class I and class II. Few patients had H-Y antibodies, with no significant differences in the prevalence of any H-Y antibody observed among transfused females (7%), transfused males (6%) and never transfused females (4%). In contrast, HLA class I, but not HLA class II, antibodies were more prevalent among transfused than never transfused patients (class I: 33% vs. 13%, P = 0·046; class II: 7% vs. 8%, P = 0·67). Among transfused patients, RBC alloantibody history but not amount of transfusion exposure was associated with a high (>25%) HLA class I panel reactive antibody (Odds ratio 6·8, 95% confidence interval 2·1-22·3). These results are consistent with immunological responder and non-responder phenotypes, wherein a subset of patients with SCD may be at higher risk for transfusion-related alloimmunization.

KEYWORDS:

H-Y; HLA antibody; alloimmunization; sickle cell disease; transfusion

PMID:
25891976
PMCID:
PMC4490004
DOI:
10.1111/bjh.13424
[Indexed for MEDLINE]
Free PMC Article

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