Arriaga F, Bonanad S, Larrea L, de la Rubia J, López F, Sanz M A, Sanz G, Marty M L
Servicio de Hematología y Hemoterapia, Hospital Universitario La Fe. Valencia.
Sangre (Barc). 1995 Jun;40(3):177-80.
To describe the immunohematological response after multiple red blood cells transfusions in 112 patients with myelodysplastic syndromes (MDS).
From 1982 to 1992 every patient with MDS entered the study. Immunohematological studies consisted of an antibody screening test (AST) and a direct antiglobulin test (DAT) at diagnosis and after every four transfused units of red blood cell concentrates.
Twenty-three out of 112 patients (20.5%) presented a positive AST and/or DAT during the study period. Eleven out of the 23 patients (9.8%) developed a positive DAT, six of them with red cell alloantibodies associated. In the remaining 12 patients (10.7%) the immune response observed was the development of red cell alloantibodies without a positive DAT. No patient presented with positive AST or DAT at diagnosis and no differences were observed in the pattern of immunohematological response and the FAB subtype.
Patients with MDS have disordered immune systems with a high prevalence of autoantibodies against red cells. However, the incidence of red cell alloimmunization is similar to that observed in other multitransfused populations. Finally, despite the high immunization rate, the absence of any hemolytical reaction make the AST and DAT a safe and effective method of pretransfusion testing in this heavily transfused population.
描述112例骨髓增生异常综合征（MDS）患者多次输注红细胞后的免疫血液学反应。
1982年至1992年，每例MDS患者均纳入研究。免疫血液学研究包括诊断时以及每输注4单位红细胞浓缩液后进行的抗体筛查试验（AST）和直接抗球蛋白试验（DAT）。
112例患者中有23例（20.5%）在研究期间AST和/或DAT呈阳性。23例患者中有11例（9.8%）DAT呈阳性，其中6例伴有红细胞同种抗体。其余12例患者（10.7%）观察到的免疫反应是红细胞同种抗体的产生，而DAT未呈阳性。诊断时无患者AST或DAT呈阳性，免疫血液学反应模式与FAB亚型之间未观察到差异。
MDS患者免疫系统紊乱，抗红细胞自身抗体的患病率较高。然而，红细胞同种免疫的发生率与其他多次输血人群中观察到的相似。最后，尽管免疫率较高，但未发生任何溶血反应，这使得AST和DAT成为该大量输血人群中安全有效的输血前检测方法。
