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A and B antigen levels acquired by group O donor-derived erythrocytes following ABO-non-identical transfusion or minor ABO-incompatible haematopoietic stem cell transplantation

Hult, A K LU ; Dykes, J H LU ; Storry, J R LU and Olsson, M L LU orcid (2017) In Transfusion Medicine 27(3). p.181-191
Abstract

BACKGROUND AND OBJECTIVES: ABO-incompatible haematopoietic stem cell transplantation (HSCT) presents a challenge to blood component transfusion. The aim of this study was to investigate the weak blood group A or B antigen expression by donor-derived group O red blood cells (RBC) observed following transfusion or minor ABO-incompatible HSCT. In addition, in vitro experiments were performed to elucidate possible mechanisms underlying this phenomenon.

MATERIALS AND METHODS: A sensitive flow cytometry assay for the semi-quantification of RBC A/B antigen levels was used to assess patient samples and evaluate in vitro experiments.

RESULTS: Analysis of blood samples from patients, originally typed as A, B and AB but recently... (More)

BACKGROUND AND OBJECTIVES: ABO-incompatible haematopoietic stem cell transplantation (HSCT) presents a challenge to blood component transfusion. The aim of this study was to investigate the weak blood group A or B antigen expression by donor-derived group O red blood cells (RBC) observed following transfusion or minor ABO-incompatible HSCT. In addition, in vitro experiments were performed to elucidate possible mechanisms underlying this phenomenon.

MATERIALS AND METHODS: A sensitive flow cytometry assay for the semi-quantification of RBC A/B antigen levels was used to assess patient samples and evaluate in vitro experiments.

RESULTS: Analysis of blood samples from patients, originally typed as A, B and AB but recently transplanted or transfused with cells from group O donors, revealed the A antigen expression on donor-derived RBC, ranging from very low levels in non-secretor individuals to almost subgroup Ax -like profiles in group A secretors. The B antigen expression was less readily detectable. In vitro experiments, in which group O donor RBC were incubated with (i) group A/B secretor/non-secretor donor plasma or (ii) group A/B donor RBC in the absence of plasma, supported the proposed adsorption of A/B antigen-bearing glycolipids from secretor plasma but also indicated a secretor-independent mechanism for A/B antigen acquisition as well as direct cell-to-cell transfer of ABO antigens.

CONCLUSION: The in vivo conversion of donor-derived blood group O RBC to ABO subgroup-like RBC after transfusion or minor ABO-incompatible HSCT raises the question of appropriate component selection. Based on these data, AB plasma should be transfused following ABO-incompatible HSCT.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Journal Article
in
Transfusion Medicine
volume
27
issue
3
pages
181 - 191
publisher
Wiley-Blackwell
external identifiers
  • pmid:28401678
  • scopus:85017521770
  • wos:000404200800004
ISSN
0958-7578
DOI
10.1111/tme.12411
language
English
LU publication?
yes
id
c5bebf8f-7faf-4ee1-900c-2ccd20a296a6
date added to LUP
2017-04-29 18:57:28
date last changed
2025-10-14 11:25:35
@article{c5bebf8f-7faf-4ee1-900c-2ccd20a296a6,
  abstract     = {{<p>BACKGROUND AND OBJECTIVES: ABO-incompatible haematopoietic stem cell transplantation (HSCT) presents a challenge to blood component transfusion. The aim of this study was to investigate the weak blood group A or B antigen expression by donor-derived group O red blood cells (RBC) observed following transfusion or minor ABO-incompatible HSCT. In addition, in vitro experiments were performed to elucidate possible mechanisms underlying this phenomenon.</p><p>MATERIALS AND METHODS: A sensitive flow cytometry assay for the semi-quantification of RBC A/B antigen levels was used to assess patient samples and evaluate in vitro experiments.</p><p>RESULTS: Analysis of blood samples from patients, originally typed as A, B and AB but recently transplanted or transfused with cells from group O donors, revealed the A antigen expression on donor-derived RBC, ranging from very low levels in non-secretor individuals to almost subgroup Ax -like profiles in group A secretors. The B antigen expression was less readily detectable. In vitro experiments, in which group O donor RBC were incubated with (i) group A/B secretor/non-secretor donor plasma or (ii) group A/B donor RBC in the absence of plasma, supported the proposed adsorption of A/B antigen-bearing glycolipids from secretor plasma but also indicated a secretor-independent mechanism for A/B antigen acquisition as well as direct cell-to-cell transfer of ABO antigens.</p><p>CONCLUSION: The in vivo conversion of donor-derived blood group O RBC to ABO subgroup-like RBC after transfusion or minor ABO-incompatible HSCT raises the question of appropriate component selection. Based on these data, AB plasma should be transfused following ABO-incompatible HSCT.</p>}},
  author       = {{Hult, A K and Dykes, J H and Storry, J R and Olsson, M L}},
  issn         = {{0958-7578}},
  keywords     = {{Journal Article}},
  language     = {{eng}},
  month        = {{04}},
  number       = {{3}},
  pages        = {{181--191}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Transfusion Medicine}},
  title        = {{A and B antigen levels acquired by group O donor-derived erythrocytes following ABO-non-identical transfusion or minor ABO-incompatible haematopoietic stem cell transplantation}},
  url          = {{https://lup.lub.lu.se/search/files/31175539/24684808.pdf}},
  doi          = {{10.1111/tme.12411}},
  volume       = {{27}},
  year         = {{2017}},
}