Abstract 4377

In men blood group incompatibilities between a donor and blood transfusion recipient may stimulate RBC antibody production, whereas in women both transfusion and pregnancies play a role. Immunogenicities of various RBC antigens correlate with their ability to induce a specific antibody response. These parameters were calculated on data obtained previously in 711 patients found to be immunized in pre-transfusion tests using the method of Giblett (Transfusion 1961), and corrected for the fraction of antibody decline in time by the method of Torney and Stack (Blood 2009).

Immunogenicities of RBC antigens expressed as a fraction of that of the K antigen (Potency = 1) are shown in columns IV & VII (method of Giblett) and in V & VIII (method of Torney & Stack) of the following table.

I Antigen XII Anti-X, NIII Anti-X, Females, NIV Females Potency vs. KV Females, Corrected PotencyVI Males, Anti-X, NVII Males, Potency Vs. KVIII Males, Corrected Potency
C 71 51 0.227 0.156 20 0.108 0.075 
c 37 27 0.164 0.141 10 0.074 0.063 
E 220 117 0.554 0.565 103 0.594 0.606 
e 9 5 0.244  4 0.238  
Fya 44 28 0.122 0.086 16 0.085 0.060 
Fyb 3 1 0.007 0.004 2 0.017 0.012 
Jka 60 41 0.225 1.083 19 0.127 0.611 
Jkb 5 3 0.015  2 0.012  
K 153 84 1 1 69 1 1 
k 1 1 0.488  0   
S 18 13 0.051 0.027 5 0.024 0.013 
s 1 0   1   
M 21 10 0.056 0.069 11 0.075 0.093 
I Antigen XII Anti-X, NIII Anti-X, Females, NIV Females Potency vs. KV Females, Corrected PotencyVI Males, Anti-X, NVII Males, Potency Vs. KVIII Males, Corrected Potency
C 71 51 0.227 0.156 20 0.108 0.075 
c 37 27 0.164 0.141 10 0.074 0.063 
E 220 117 0.554 0.565 103 0.594 0.606 
e 9 5 0.244  4 0.238  
Fya 44 28 0.122 0.086 16 0.085 0.060 
Fyb 3 1 0.007 0.004 2 0.017 0.012 
Jka 60 41 0.225 1.083 19 0.127 0.611 
Jkb 5 3 0.015  2 0.012  
K 153 84 1 1 69 1 1 
k 1 1 0.488  0   
S 18 13 0.051 0.027 5 0.024 0.013 
s 1 0   1   
M 21 10 0.056 0.069 11 0.075 0.093 
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In males the corrected potencies of E and Jka were about 60% of that of K, but in females the corrected potencies of Jka and K were equal. The antigens C, c, Fya,Jka and S had higher corrected

potencies in females than in males, probably reflecting the additional role of pregnancies in immunization. Note the big difference in antibody response between allelic non-Rh antigens (e.g. Jka vs. Jkb).

Immunogenicity of the Rh D antigen was not calculated since Rh negative patients receive Rh negative blood and Rh negative pregnant women are given Rh immune prophylaxis. However, in this study 29.6 % of the patients were Rh negative. Over 70% of the susceptible patients had been immunized to the Rh D.

In conclusion, RBC antibodies interfere with the benefits of RBC transfusions and may also cause severe adverse effects. Introduction of molecular methods into Blood Bank setting could eventually minimize exposure and immunization of transfusion recipients to incompatible RBC antigens. Information about immunogenicity of various blood group antigens may point out those antigens that should not be given to patients who are lacking them. It is also critical to understand why immunization to the D antigen is still prevalent in order to pave the way to future multiple antigen matching.

Disclosures:

No relevant conflicts of interest to declare.

Topics:
antigens, blood group antigens, immunization, immunogenicity, transfusion, rh negative, antibodies, d antigen, adverse effects, blood group incompatibility
© 2012 by The American Society of Hematology
2012
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