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Leuk Res. 2017 Aug;59:12-19. doi: 10.1016/j.leukres.2017.05.006. Epub 2017 May 9.

Red blood cell alloimmunization in 184 patients with myeloid neoplasms treated with azacitidine - A retrospective single center experience.

Author information

1
3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Laboratoy for Immunological and Molecular Cancer Research, Oncologic Center, Paracelsus Medical University, Salzburg, Austria; Center for Clinical Cancer and Immunology Trials as Salzburg Cancer Research Institute, Salzburg, Austria.
2
Department of Blood Group Serology and Transfusion Medicine, SALK - Paracelsus Medical University, Salzburg Austria.
3
Austrian Red Cross, Blood Service for Vienna, Lower Austria and Burgenland, Vienna, Austria.
4
3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Laboratoy for Immunological and Molecular Cancer Research, Oncologic Center, Paracelsus Medical University, Salzburg, Austria; Center for Clinical Cancer and Immunology Trials as Salzburg Cancer Research Institute, Salzburg, Austria; Cancer Cluster, Salzburg, Austria.
5
3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Laboratoy for Immunological and Molecular Cancer Research, Oncologic Center, Paracelsus Medical University, Salzburg, Austria; Center for Clinical Cancer and Immunology Trials as Salzburg Cancer Research Institute, Salzburg, Austria; Cancer Cluster, Salzburg, Austria. Electronic address: l.pleyer@salk.at.

Abstract

Alloimmunization to Red Blood Cell (RBC) antigens frequently occurs in patients with myeloid neoplasms (AML, MDS and CMML) and potentially poses the patient at risk for delayed hemolytic transfusion reactions and limited supply of compatible RBC-units. However, there is comparatively little data on transfusion associated characteristics in this patient cohort. We therefore retrospectively analyzed transfusion requirements and clinical outcomes of 184 patients with myloid neoplasms treated with azacitidine at the Paracelsus Medical University Salzburg, which were included in the Austrian Registry of Hypomethylating Agents. The mean blood component requirements for AML, MDS and CMML were 39.8, 67.4 and 31.4 RBC units and 31.7, 27.6 and 19.1 platelet (PLT) units respectively. In spite of an extended and stringent RBC unit matching policy (ABO, RhD, RhCcEe and K antigens), 20 (11%) patients formed at least one alloantibody ("allo-group"), whereas 164 patients (89%) did not ("non-allo-group"). The most frequent antibody specificity was anti-E, followed by anti-Wra -Lua, -D, -C and -Jka. Alloimmunization was associated with higher numbers of transfused RBC units (68 vs. 38; p=0.001), as well as with longer time under transfusion (16.7 vs. 9.4 months; p=0.014). Median overall survival (OS) did not differ significantly between the "allo"- and "non-allo-group".

KEYWORDS:

Acute myeloid leukemia; Alloimmunization; Azacitidine; Myelodysplastic syndrome chronic myelomonocytic leukemia; Red blood cell transfusion

PMID:
28535394
DOI:
10.1016/j.leukres.2017.05.006
[Indexed for MEDLINE]
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