Patients with Asian-type DEL can safely be transfused using RhD-positive blood
| العنوان: | Patients with Asian-type DEL can safely be transfused using RhD-positive blood |
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| المؤلفون: | Yanli Ji, Yalin Luo, Jizhi Wen, Yuanfan Sun, Shuangshuang Jia, Chunquan Ou, Wenbing Yang, Jingwang Chen, Hanshen Ye, Xiangfu Liu, Yongneng Liang, Zhigang Lu, Ying Feng, Xinzhong Wu, Muzhou Xiao, Jiankun Mo, Zhenhai Zhou, Zhen Wang, Zhijian Liao, Junhu Chen, Ling Wei, Guangping Luo, Sentot Santoso, Yann Fichou, Willy A Flegel, Chaopeng Shao, Chengyao Li, Rui Zhang, Yongshui Fu |
| المصدر: | Blood. |
| بيانات النشر: | American Society of Hematology, 2023. |
| سنة النشر: | 2023 |
| مصطلحات موضوعية: | Immunology, Cell Biology, Hematology, Biochemistry |
| الوصف: | Red blood cells (RBCs) of the Asian-type DEL phenotype express few RhD proteins and are typed as serologic RhD-negative (D-) in routine testing. RhD-positive (D+) RBC transfusion for Asian-type DEL patients has been proposed but has not been generally adopted due to a lack of direct evidence regarding its safety and underlying mechanism. We performed a single-arm multicenter clinical trial to document the outcome of D+ RBC transfusion in Asian-type DEL patients; none of the recipients (0/42; 95% confidence interval, 0%-8.40%) developed alloanti-D after a median follow-up of 226 days. We conducted a large retrospective study to detect alloanti-D immunization in 4,045 serologic D- pregnant women throughout China; alloanti-D was found only in true D- individuals (2.63%, 79/3,009), but not in those with Asian-type DEL (0/1,032). We further retrospectively examined 127 serologic D- pregnant women who had developed alloanti-D and found none with Asian-type DEL (0/127). Finally, we analyzed RHD transcripts from Asian-type DEL erythroblasts and examined antigen epitopes expressed by various RHD transcripts in vitro, finding a low abundance of full-length RHD transcripts (0.18% of the total) expressing RhD antigens carrying the entire repertoire of epitopes, which could explain the immune tolerance against D+ RBCs. Our results provide multiple lines of evidence that individuals with Asian-type DEL cannot produce alloanti-D when exposed to D+ RBCs following transfusion or pregnancy. Therefore, we recommend considering D+ RBC transfusion and discontinuing anti-D prophylaxis in Asian-type DEL patients, including pregnant women. This clinical trial is registered at www.clinicaltrials.gov as NCT03727230. |
| تدمد: | 1528-0020 0006-4971 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::8730bb9721cbb8e8ec781d5998a061b0 https://doi.org/10.1182/blood.2022018152 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi...........8730bb9721cbb8e8ec781d5998a061b0 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15280020 00064971 |
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