| HLA alloimmunization is associated with RBC antibodies in multiply transfused patients with sickle cell disease. | |
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MedLine Citation:
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PMID: 19890898 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Alloimmunization to minor red blood cell (RBC) antigens occurs commonly in sickle cell disease (SCD). Patients with alloimmunization demonstrate increased risk for new alloantibody formation with subsequent transfusion. Alloimmunization to human leukocyte antigens (HLA) can occur with RBC transfusion and may result in graft rejection during stem cell or organ transplantation. The prevalence and risk factors for HLA alloimmunization in multiply transfused pediatric SCD patients are unknown. PROCEDURE: A cross-sectional study of HLA alloimmunization in SCD patients aged 3-21 years with a history of >or=3 RBC transfusions was performed to test the hypothesis that HLA alloimmunization is associated with RBC alloimmunization. Antibodies to class I and class II HLA were measured by Flow Panel Reactive Antibody (FlowPRA). RESULTS: Seventy-three SCD patients (30 with RBC antibodies) were tested. HLA antibodies were detected in 25/73 (34%) patients; class I HLA antibodies occurred in 24/73 (33%) and class II HLA antibodies occurred in 3 (4%). Among patients with RBC antibodies, 16/30 (53%) had HLA antibodies, while 9/43 (21%) patients without RBC antibodies had HLA antibodies (OR 4.32 [1.6-12.1]). In a multivariate analysis, antibodies to RBC antigens were an independent predictor of HLA alloimmunization (P = 0.041). The association of RBC and HLA immunization was strongest among patients with no history of chronic transfusion therapy. CONCLUSIONS: This analysis is the first description of HLA alloimmunization in pediatric SCD patients who receive primarily leukoreduced RBC transfusions and demonstrates that HLA alloimmunization tendency is associated with antibodies to RBC antigens. |
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Authors:
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Marianne E McPherson; Alan R Anderson; Marta-In?s Castillejo; Christopher D Hillyer; Robert A Bray; Howard M Gebel; Cassandra D Josephson |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Pediatric blood & cancer Volume: 54 ISSN: 1545-5017 ISO Abbreviation: Pediatr Blood Cancer Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-02-17 Completed Date: 2010-04-19 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101186624 Medline TA: Pediatr Blood Cancer Country: United States |
Other Details:
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Languages: eng Pagination: 552-8 Citation Subset: IM |
Affiliation:
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Aflac Cancer Center and Blood Disorders Services, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA. marianne.mcpherson@choa.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Anemia, Sickle Cell / blood, immunology, therapy* Child Child, Preschool Cross-Sectional Studies Erythrocyte Transfusion / adverse effects* Erythrocytes / immunology* HLA Antigens / immunology Humans Isoantibodies / blood* Isoantigens / immunology* Prevalence Risk Factors Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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HL07001/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/HLA Antigens; 0/Isoantibodies; 0/Isoantigens |
| Comments/Corrections | |
Comment In:
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Pediatr Blood Cancer. 2010 Apr;54(4):499-500
[PMID:
19998466
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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