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Post-transfusion biotin-labeled red blood cell survival studies in pediatric sickle cell disease with antibodies of uncertain significance.
Yee, Marianne E M; Zerra, Patricia E; McCoy, James W; Covington, Mischa L; Stowell, Sean R; Joiner, Clinton H; Lough, Christopher M; Delvadia, Bhaveshkumar B; Josephson, Cassandra D; Roback, John D; Fasano, Ross M.
Afiliación
  • Yee MEM; Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
  • Zerra PE; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.
  • McCoy JW; Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
  • Covington ML; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Stowell SR; Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Joiner CH; Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Lough CM; Joint Program in Transfusion Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
  • Delvadia BB; Joint Program in Transfusion Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
  • Josephson CD; Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
  • Roback JD; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Fasano RM; Medical Services, Lifesouth Community Blood Centers, Gainesville, Florida, USA.
Transfusion ; 64(5): 800-807, 2024 May.
Article en En | MEDLINE | ID: mdl-38506450
ABSTRACT

BACKGROUND:

Red blood cell (RBC) antibodies are common in multiply transfused patients with sickle cell disease (SCD). Unlike RBC alloantibodies, the potential of autoantibodies to cause post-transfusion hemolysis may be uncertain. Biotin-labeling provides a direct measurement of red cell survival (RCS) over time, thus can be used to assess the clinical significance of RBC antibodies. Antibodies to biotinylated RBC (B-RBC) occasionally are detected after exposure, which may impact B-RBC survival in subsequent RCS studies. STUDY DESIGN AND

METHODS:

Pediatric patients with SCD receiving monthly chronic transfusions underwent RCS studies, receiving aliquots of allogeneic RBC labeled at distinct densities of biotin (2-18 µg/mL). B-RBC survival was followed for 4 months post-transfusion, and B-RBC antibody screening for 6 months. Patients with warm autoantibodies (WAA) or B-RBC antibodies are reported here.

RESULTS:

RBC antibodies were detected during RCS in four patients one with WAA, one with WAA followed by B-RBC-specific antibodies, and two with transient B-RBC antibodies within the first 5 weeks of exposure. B-RBC half-lives (T50) ranged 37.6-61.7 days (mean 47.8 days). There was no evidence of increased hemolysis or accelerated B-RBC clearance in the presence of WAA or B-RBC antibodies.

DISCUSSION:

Biotinylation of allogenic RBC can be used to assess the possible effects of RBC antibodies on transfusion survival in individual cases, particularly when it is uncertain if the detected antibodies may result in hemolysis. In the cases presented here, neither WAA nor B-RBC antibodies were associated with significant shortening of B-RBC survival in individuals with SCD.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Autoanticuerpos / Biotina / Transfusión de Eritrocitos / Eritrocitos / Anemia de Células Falciformes Límite: Adolescent / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Transfusion Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Autoanticuerpos / Biotina / Transfusión de Eritrocitos / Eritrocitos / Anemia de Células Falciformes Límite: Adolescent / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Transfusion Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos