Post-transfusion biotin-labeled red blood cell survival studies in pediatric sickle cell disease with antibodies of uncertain significance

© 2024 AABB..

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.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - year:2024

Enthalten in:

Transfusion - (2024) vom: 20. März

Sprache:

Englisch

Beteiligte Personen:

Yee, Marianne E M [VerfasserIn]
Zerra, Patricia E [VerfasserIn]
McCoy, James W [VerfasserIn]
Covington, Mischa L [VerfasserIn]
Stowell, Sean R [VerfasserIn]
Joiner, Clinton H [VerfasserIn]
Lough, Christopher M [VerfasserIn]
Delvadia, Bhaveshkumar B [VerfasserIn]
Josephson, Cassandra D [VerfasserIn]
Roback, John D [VerfasserIn]
Fasano, Ross M [VerfasserIn]

Links:

Volltext

Themen:

Biotin
Journal Article
RBC autoantibodies
Red cell survival
Sickle cell disease

Anmerkungen:

Date Revised 20.03.2024

published: Print-Electronic

Citation Status Publisher

doi:

10.1111/trf.17800

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM369960548