Moreira Júnior G, Bordin J O, Kuroda A, Kerbauy J
Disciplina de Hematologia e Hemoterapia, Universidade Federal de São Paulo, Escola Paulista de Medicina, Brazil.
Am J Hematol. 1996 Jul;52(3):197-200. doi: 10.1002/(SICI)1096-8652(199607)52:3<197::AID-AJH11>3.0.CO;2-D.
Red blood cell (RBC) transfusions are widely used in the management of patients with sickle cell disease (SCD). However, repeated RBC transfusions are often complicated by RBC alloimmunization. To investigate whether the frequency of RBC alloimmunization could be accounted for by racial and RBC phenotype differences between donors and recipients in Brazil, in this study we compared the RBC phenotype of 100 SCD patients with that observed in 120 randomly selected blood donors. A comparison of the RBC phenotype between the two groups revealed a statistically significant increase in the frequency of the C antigen in the donor population (P < 0.01), but no significant difference was observed for the A,B,D,c,E,e,K,k,Fya,M,N,S,s, and Jka antigens. Using standard techniques (indirect antiglobulin test, enzyme treatment, and low-ionic-strength solution) we observed an RBC alloimmunization rate of 12.9% (11/85) in the SCD patients. Fifteen alloantibodies were detected in 11 patients, and most (80%) involved antigens in the Rhesus and Kell systems. This observed RBC alloimmunization rate in SCD patients in Brazil is lower than that reported by studies from North America, suggesting that the requirement for extended antigen-matched RBC transfusion for SCD patients in the setting of a RBC phenotype concordant donor-recipient population may not be cost-effective in some countries.
红细胞（RBC）输血广泛应用于镰状细胞病（SCD）患者的治疗。然而，反复进行红细胞输血常并发红细胞同种免疫。为了调查在巴西红细胞同种免疫的频率是否可归因于供者和受者之间的种族及红细胞表型差异，在本研究中，我们比较了100例SCD患者与120例随机选择的献血者的红细胞表型。两组之间红细胞表型的比较显示，供者群体中C抗原的频率有统计学显著增加（P < 0.01），但A、B、D、c、E、e、K、k、Fya、M、N、S、s和Jka抗原未观察到显著差异。使用标准技术（间接抗球蛋白试验、酶处理和低离子强度溶液），我们观察到SCD患者的红细胞同种免疫率为12.9%（11/85）。在11例患者中检测到15种同种抗体，大多数（80%）涉及恒河猴和凯尔血型系统中的抗原。巴西SCD患者中观察到的这种红细胞同种免疫率低于北美研究报告的水平，这表明在红细胞表型一致的供者 - 受者群体中，为SCD患者提供扩展抗原匹配的红细胞输血在某些国家可能不具有成本效益。
