Format

Send to

Choose Destination
Vox Sang. 2019 Jun 10. doi: 10.1111/vox.12797. [Epub ahead of print]

Prevalence and laboratorial determinants of the clinical relevance of antibodies of undetermined specificity.

Author information

1
Fundação Pró-Sangue, Hemocentro de São Paulo, São Paulo, Brazil.
2
Serviço de Hematologia, Hemoterapia e Terapia Celular, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
3
Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), São Paulo, Brazil.
4
Institute of Tropical Medicine, Universidade de São Paulo, São Paulo, Brazil.
5
Department of Hematology, Churchill Hospital NHS BT, Oxford University, Oxford, UK.

Abstract

BACKGROUND AND OBJECTIVES:

Antibodies of unknown specificity (AUS) are frequently identified in the pre-transfusion testing. These antibodies can be insignificant or potentially cause post-transfusion haemolysis. Information about the prevalence of clinically relevant AUS is still lacking. Our aim was to predict the potential clinical relevance of AUS using the monocyte monolayer assay (MMA) and to identify the clinical and laboratorial determinants of AUS' significance.

MATERIALS AND METHODS:

Antibodies of unknown specificity identified at a single institution from 2015-2017 were evaluated through MMA. A monocyte index (MI) of more than 5% was predictive of potential post-transfusion haemolysis.

RESULTS:

Thirty-two patients with AUS were included in the study. Of the studied AUS, 37·5% (12/32) presented with a monocyte index (MI) more than 5%. In the group of significant AUS, 41·7% of the patients presented with sickle cell disease (SCD) and the AUS were associated with Rh antibodies in 75% of the cases. In the group of insignificant AUS, only 10% of the patients had SCD and the association with Rh antibodies was detected in 20% of the cases. The presence of Rh antibodies was independently associated with the AUS clinical relevance (P = 0·012).

CONCLUSION:

More than one-third of the AUS are potentially clinically relevant, and the association with Rh antibodies is predictive of AUS relevance. Services must honour AUS in the pre-transfusion process in order to ensure transfusion safety.

KEYWORDS:

Rh; antibodies of undetermined specificity; monocyte monolayer assay; post-transfusion haemolytic reactions

PMID:
31183870
DOI:
10.1111/vox.12797

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center