Komatsu F, Kajiwara M
Blood Transfusion Service, School of Medicine, Tokyo Medical and Dental University, Japan.
Transfus Med. 1996 Jun;6(2):139-43. doi: 10.1046/j.1365-3148.1996.d01-63.x.
Three years ago, a 71-year-old female was admitted because of general lymphadenopathy. She had been on medication for hypothroidism, but had no history of pregnancy or blood transfusion. T-cell lymphoma was found. Since then, she has been treated with intermittent chemotherapy. The patient's LWa antigen was depressed during two relapses of the lymphoma and anti-LWa was detected simultaneously on both occasions. When she entered remission after therapy, her LW phenotype converted from LW(a-) to LW(a+), and this was accompanied by the disappearance of anti-LWa. This suggests that LW(a-) was a transient phenotype. In the first relapse, a total of 8 units of D- LW(a+) packed red cells and 20 units of platelets were transfused during 1 month without any haemolytic reaction. In these relapses, nonhaemolytic anaemia, hyper-gamma-globulinaemia and remarkable bone-marrow infiltration with lymphoplasma cells were recognized. She also possessed antithyroglobulin and antimicrosomal antibodies; however, these autoantibodies did not change with the relapses. These results suggests that the recurrent depressions of LWa may be closely related to the underlying disease.
三年前，一名71岁女性因全身淋巴结肿大入院。她一直在接受甲状腺功能减退症的治疗，但无妊娠或输血史。发现患有T细胞淋巴瘤。从那时起，她接受了间歇性化疗。在淋巴瘤的两次复发期间，患者的LWa抗原降低，且两次均同时检测到抗LWa。当她在治疗后进入缓解期时，其LW表型从LW(a-)转变为LW(a+)，同时抗LWa消失。这表明LW(a-)是一种短暂的表型。在首次复发时，在1个月内共输注了8单位D型LW(a+)浓缩红细胞和20单位血小板，未发生任何溶血反应。在这些复发中，发现了非溶血性贫血、高γ球蛋白血症以及淋巴细胞浆细胞显著浸润骨髓。她还拥有抗甲状腺球蛋白和抗微粒体抗体；然而，这些自身抗体并未随复发而改变。这些结果表明，LWa的反复降低可能与基础疾病密切相关。
