Red Blood Cell Transfusions Are Associated with HLA Class I but not H-Y Allo antibodies in Children with Sickle Cell Disease Público

Abstract

Blood transfusions can induce alloantibodies to antigens on red blood cells (RBCs), white blood cells, and platelets, with these alloantibodies having importance in transfusion and transplantation. While transfusion-related alloimmunization against RBC antigens and human leukocyte antigens (HLA) have been studied, transfusion-related alloimmunization to minor histocompatibility antigens (mHA) such as H-Y antigens has not been clinically characterized. We thus conducted a cross-sectional study of 114 children with sickle cell disease (SCD) and measured 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). After adjustment for age, splenectomy, and hydroxyurea this association between RBC transfusion and HLA class I alloimmunization remained significant.(p=0.042). Among transfused patients, RBC alloantibody history but not the amount of RBC transfusion exposure was associated with a high (>25%) HLA class I panel reactive antibody (PRA) on both univariate (OR 6.8, 95% CI 2.1-22.3) and multivariable analysis (OR 6.3, 95% CI 1.7-22.6). These results are consistent with immunologic responder and non-responder phenotypes, wherein a subset of patients with SCD may be at higher risk for transfusion-related alloimmunization.

Table of Contents

Introduction, 1-2.

Background, 3-7.

Methods, 8-12.

Results, 13-16.

Discussion, 17-20.

References, 21-27.

Tables and Figures, 28-40.

About this Master's Thesis

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School	Laney Graduate School
Department	Clinical Research Curriculum Program
Degree	MS
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Immunology
Palavra-chave	alloimmunization sickle cell disease transfusion
Committee Chair / Thesis Advisor	Horan, John T, Emory University
Committee Members	Kempton, Christine, Emory University Klein, Mitchel, Emory University

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