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Alloimmunization to D antigen and HLA in D‐negative immunosuppressed oncology patients
Author(s) -
Baldwin M.L.,
Ness P.M.,
Scott D.,
Braine H.,
Kickler T.S.
Publication year - 1988
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1046/j.1537-2995.1988.28488265260.x
Subject(s) - medicine , antigen , antibody , isoantibodies , human leukocyte antigen , gastroenterology , immunology
D‐negative patients may be divided into responders and nonresponders when immunized with D‐positive red cells (RBC). Forty‐nine D‐negative oncology patients who received D‐positive RBCs via platelet and white cell transfusions were studied to determine if nonresponders to D were likely to form lymphocytotoxic antibody (LCA). Nine patients developed anti‐D in 16 to 390 days (x̄ = 112) after 2.6 to 481 ml (x̄ = 106) of D‐positive RBCs. Forty patients had no evidence of anti‐D after 0.8 to 535 ml (x̄ = 98) of D‐positive RBCs and were followed for 14 to 1275 days (x̄ = 192). The anti‐D group had no prior D‐positive RBC transfusions, and two of five women making anti‐D had previous pregnancies but no record of anti‐D. LCA was found in four of nine (44%) patients with anti‐D and in 12 of 40 (30%) patients without anti‐D (p < 0.50). Since both D and antigens HLA are considered highly immunogenic, it is of interest that the ability to form anti‐D or LCA does not correlate. In fact, more patients (16/49; 32%) made LCA than anti‐D (9/49; 18%). Of the 21 alloimmunized patients, 4 made both antibodies, while 17 had selective alloimmunization. It would thus appear that alloimmunization to D and HLA are not strongly linked and may indeed be unrelated.