Jiang Feiyu, Song Tiejun, Wang Yingjian, Liu Zhiwei
Department of Blood Transfusion, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Front Med (Lausanne). 2022 May 16;9:904296. doi: 10.3389/fmed.2022.904296. eCollection 2022.
ABO blood group system is the most important blood group system in transfusion and transplantation medicine. Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphomas (NHLs) worldwide. There have been some studies that lymphoma could affect ABO blood group system and thus affect blood transfusion strategy. However, the mechanisms lymphoma affecting ABO blood group system have not been fully elucidated so far. Here, we report a case of a patient who was a 72-year-old Chinese man came to our hospital for medical advice because of cervical lymphadenophathy. The patient was subsequently diagnosed with diffuse large B-cell lymphoma by lymph-node biopsy. His ABO blood group was initially typed as B on November 7, 2020. He was transfusing B type leukocyte poor RBCs (LPR) before we found the patient's ABO blood group discrepancy on December 2, 2020 by forward and reverse typing methods, which the discrepancy was verified by genotyping. The patient began to transfuse O type washed RBCs (WRBC) since then. Compared to transfuse B type leukocyte poor RBCs (LPR), the efficiency of transfusing O type washed RBCs (WRBC) was better. Although hemoglobin level did not greatly improve, indirect bilirubin level evidently decreased. Furthermore, we found B-cell lymphoma affected blood transfusion strategy by producing IgM anti-B antibody in this case. Clinicians should need to be aware of the effect of B-cell lymphoma on blood transfusion strategy.
ABO血型系统是输血和移植医学中最重要的血型系统。弥漫性大B细胞淋巴瘤（DLBCL）是全球最常见的非霍奇金淋巴瘤（NHL）类型。已有一些研究表明淋巴瘤可能影响ABO血型系统，进而影响输血策略。然而，迄今为止淋巴瘤影响ABO血型系统的机制尚未完全阐明。在此，我们报告一例病例，患者为一名72岁中国男性，因颈部淋巴结肿大前来我院咨询。该患者随后经淋巴结活检确诊为弥漫性大B细胞淋巴瘤。其ABO血型最初于2020年11月7日被鉴定为B型。在2020年12月2日我们通过正反定型法发现患者ABO血型存在差异（该差异经基因分型验证）之前，他一直在输注B型少白细胞红细胞（LPR）。此后该患者开始输注O型洗涤红细胞（WRBC）。与输注B型少白细胞红细胞（LPR）相比，输注O型洗涤红细胞（WRBC）的效果更好。虽然血红蛋白水平没有显著提高，但间接胆红素水平明显下降。此外，我们发现在该病例中B细胞淋巴瘤通过产生IgM抗B抗体影响输血策略。临床医生应意识到B细胞淋巴瘤对输血策略的影响。
