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Red blood cell transfusions are associated with HLA class I but not H‐Y alloantibodies in children with sickle cell disease
Author(s) -
Nickel Robert S.,
Hendrickson Jeanne E.,
Yee Marianne M.,
Bray Robert A.,
Gebel Howard M.,
Kean Leslie S.,
Miklos David B.,
Horan John T.
Publication year - 2015
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.13424
Subject(s) - medicine , human leukocyte antigen , immunology , antigen , antibody , isoantibodies , blood transfusion , histocompatibility , panel reactive antibody , red blood cell , odds ratio , transplantation , leukoreduction
Summary Blood transfusions can induce alloantibodies to antigens on red blood cells ( RBC s), white blood cells and platelets, with these alloantibodies affecting transfusion and transplantation. While transfusion‐related alloimmunization against RBC antigens and human leucocyte antigens ( HLA ) have been studied, transfusion‐related alloimmunization to minor histocompatibility antigens ( mHA ), such as H‐Y antigens, has not been clinically characterized. We conducted a cross‐sectional study of 114 children with sickle cell disease ( SCD ) and tested for antibodies to 5 H‐Y antigens and to HLA class I and class II . Few patients had H‐Y antibodies, with no significant differences in the prevalence of any H‐Y antibody observed among transfused females (7%), transfused males (6%) and never transfused females (4%). In contrast, HLA class I, but not HLA class II , antibodies were more prevalent among transfused than never transfused patients (class I: 33% vs. 13%, P = 0·046; class II : 7% vs. 8%, P = 0·67). Among transfused patients, RBC alloantibody history but not amount of transfusion exposure was associated with a high (>25%) HLA class I panel reactive antibody (Odds ratio 6·8, 95% confidence interval 2·1–22·3). These results are consistent with immunological responder and non‐responder phenotypes, wherein a subset of patients with SCD may be at higher risk for transfusion‐related alloimmunization.