Department of Laboratory Medicine, Shinshu University Hospital, Matsumoto, Japan.
Life Science Research Centre, Nagano Children's Hospital, Azumino, Japan.
Blood Transfus. 2022 Mar;20(2):94-102. doi: 10.2450/2021.0230-20. Epub 2021 Feb 3.
Allergic transfusion reactions (ATR) and febrile non-haemolytic transfusion reactions (FNHTR) are common transfusion-related adverse reactions; however, their pathogenesis remains unclear and it is difficult to predict their occurrence. Single-nucleotide polymorphisms (SNP) are related to the onset of various diseases and therapy-related adverse events; therefore, identification of SNP related to transfusion-related adverse reactions may help to elucidate the underlying mechanism and predict the onset of these reactions.
We retrospectively analysed the association between the onset of ATR or FNHTR and 22 allergic sensitisation-related SNP in 219 children (aged ≤20 years) who had haematological and oncological diseases and who had received transfusions of platelets and/or red blood cell concentrates.
Among the 219 children, 105 had developed an ATR and/or FNHTR at least once. The patients who developed ATR frequently had a risk allele in rs6473223, while the patients who developed FNHTR frequently had a risk allele in rs10893845. Furthermore, patients who developed ATR accompanied by febrile symptoms also frequently had a risk allele in rs10893845, similar to patients who developed FNHTR.
The results suggested that allergic sensitisation is associated with the onset of ATR and/or FNHTR in some patients. Although further prospective evaluation is necessary, analysis of these SNP might help to provide safer transfusion therapy by predicting patients at higher risk of transfusion-related adverse reactions and further clarifying the pathogenic mechanism underlying such reactions.
过敏输血反应(ATR)和发热非溶血性输血反应(FNHTR)是常见的输血相关不良反应;然而,其发病机制尚不清楚,难以预测其发生。单核苷酸多态性(SNP)与各种疾病和治疗相关不良事件的发生有关;因此,鉴定与输血相关不良反应相关的 SNP 可能有助于阐明其发病机制并预测这些反应的发生。
我们回顾性分析了 219 例患有血液系统和肿瘤疾病并接受血小板和/或浓缩红细胞输注的≤20 岁儿童中 22 个过敏致敏相关 SNP 与 ATR 或 FNHTR 发生之间的关系。
在 219 例儿童中,105 例至少发生过一次 ATR 和/或 FNHTR。发生 ATR 的患者 rs6473223 风险等位基因频繁出现,而发生 FNHTR 的患者 rs10893845 风险等位基因频繁出现。此外,伴有发热症状的 ATR 患者 rs10893845 风险等位基因也频繁出现,类似于发生 FNHTR 的患者。
结果表明,过敏致敏与某些患者发生 ATR 和/或 FNHTR 有关。尽管需要进一步前瞻性评估,但这些 SNP 的分析可能有助于通过预测输血相关不良反应风险较高的患者,提供更安全的输血治疗,并进一步阐明这些反应的发病机制。