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Clinical Trial
. 2019 Oct;104(10):e451-e454.
doi: 10.3324/haematol.2018.215087. Epub 2019 Feb 28.

Red cell autoimmunization and alloimmunization in myelodysplastic syndromes: prevalence, characteristic and significance

Rakchha Chhetri  1   2 , Li Yan A Wee  1   2 , Romi Sinha  3 , Monika M Kutyna  2   4 , Anh Pham  5 , Helen Stathopoulos  5 , Lakshmi Nath  6 , Shriram V Nath  6   7 , Nicholas Wickham  8 , Tim Hughes  1   2   4 , Deepak Singhal  1   2   4 , David J Roxby  5   9 , Devendra K Hiwase  10   2   4
Affiliations
Clinical Trial

Red cell autoimmunization and alloimmunization in myelodysplastic syndromes: prevalence, characteristic and significance

Rakchha Chhetri et al. Haematologica. 2019 Oct.
No abstract available

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Figures

Figure 1.
Figure 1.
Distribution of alloantibodies in myelodysplastic syndromes (MDS). (A) Distribution of alloantibodies in 115 patients. Each column represents an alloantibody-positive patient and each row represents alloantibody specificity. Blue color in each box represents the presence of that specific alloantibody. The bars on the right represent the frequencies of each alloantibody in alloantibody-positive patients. (B) Comparing frequency of positive direct antiglobulin tests (DAT) in non-transfused, transfused, alloimmunized, and non-alloimmunized MDS patients. (C) Comparison of elution results between non-alloimmunized and alloimmunized patients who had elution tests. The number of patients with reactive eluates are shown in the bar diagram. (D) Cumulative incidence of autoantibody in patients with single (n=45) and multiple alloantibodies (n=41), as well as non-alloimmunized patients (n=663). No: number; RBC: red blood cell; Tx: transfusion; DAT: direct agglutination tests; Alloab: alloantibodies; Autoab: autoantibodies; pos: positive; neg: negative.
Figure 2.
Figure 2.
Alloimmunization is associated with increased risk of autoimmunization and increased red blood cell (RBC) transfusion intensity. (A) Cox proportional hazard model showing autoimmunization risk is highest in patients with alloimmunization (n=749). (B) Timing of autoimmunization in relation with alloantibodies (Alloab). RBC transfusion intensity significantly increased after alloimmunization in (C) eligible, (D) single, and (E) multiple alloantibody cohorts.
Figure 3.
Figure 3.
Autoimmunization is associated with significant increase in red blood cell (RBC) transfusion intensity in alloimmunized patients. As compared to pre-alloimmunization period, RBC transfusion intensity significantly increased during post-alloimmunization periods in (A) all eligible, (B) single, and (C) multiple alloantibody patients developing autoantibodies. While RBC transfusion requirement did not change significantly during the post-alloimmunization period in (D-F) all eligible and multiple alloantibody patients without autoantibodies, except patients with single alloantibody.
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