Zhongguo shuxue zazhi (May 2024)
Correlation between unexpected antibody types and transfusion efficacy in patients with autoimmune hemolytic anemia (AIHA)
Abstract
Objective To analyze the antibody types of autoimmune hemolytic anemia(AIHA) patients in Panyu district, Guangzhou and track the therapeutic effect of blood transfusion, so as to provide reference for clinical transfusion treatment strategy of AIHA patients. Methods From January 2021 to October 2023, 96 ambiguous cross-matching blood samples from Blood Transfusion Departments of local hospitals sent to Panyu Central Blood Station were analyzed, and 25 samples of AIHA patients were identified. Then blood group identification, Rh system antigen phenotyping, antibody screening and cross-matching were further performed to analyze the correlation between antibody types and transfusion efficacy in AIHA patients. Results Among the 25 samples of AIHA patients, 17 showed consistency between forward and reverse blood grouping and 8 showed discrepancy. There were 19 (19/25, 76%) samples incompatible in cross match on the major side, of which 18 (18/19, 94.7%) were positive for direct Coombs test, autoantibodies and non-specific antibodies, and 1 (1/19, 5.3%)was positive for autoantibody and alloantibody.There were 6 (6/25, 24%) samples compatible in cross match on the major side, of which 3 (3/6, 50%) were positive for autoantibodies, 3 (3/6, 50%) were positive for autoantibody and alloantibody. Of the 25 AIHA patients, 20 received blood transfusion treatment and could be traced, and 5 patients did not receive blood transfusion treatment or transferred to other hospitals and could not be traced. Blood transfusion was effective in 11 (11/20, 55%) cases, partially effective in 6 (6/20, 30%) cases, and ineffective in 3 (3/20, 15%) cases. Among the ABO blood group incompatibility samples, transfusion was effective or partially effective in 17 (17/20, 85%) cases. Conclusion The transfusion efficacy of AIHA patients is not directly related to the results of cross-matching. Under the premise of regulating the autoimmune environment and eliminating the ABO blood group incompatibility caused by unexpected alloantibodies, AIHA patients with incompatible cross-matching can be transfused when necessary, and transfusion of ABO and Rh system antigen homologous blood can improve the safety and efficiency of transfusion.
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