The Characteristics of Concurrent Blood Group Antibodies Detected by Unexpected Antibody Screening Tests

Kim, Ji Eun; Kim, Bo Ram; Woo, Kwang Sook; Han, Jin Yeong; Kim, Kyeong Hee

Abstract

BACKGROUND
Multiple alloimmunization is the production of two or more alloantibodies by an individual. These antibodies are significant because they can present major problems in compatibility testing. The goal of this study was to determine the properties of concurrent blood group (BG) antibodies in Korea.
METHODS
The transfusion records of 540 patients from Dong-A University Hospital were reviewed to identify alloimmunized individuals. The records spanned a time period from September 2002 to March 2010. The data regarding transfusions and the clinical characteristics of those patients making concurrent antibodies were gathered.
RESULTS
Concurrent blood group antibodies were found in 23.9% (45/188) of alloimmunized patients, constituting 40.7% (100/246) of all antibodies. The most common alloantibody pair were anti-E/-c and anti-C/-e. The mean transfused RBC units, mean interval, and mean transfusion frequencies before detection of two or more antibodies were 2.4 units, 92 days, and 2.4 times, respectively. The majority of alloantibody pairs appeared and were undetectable at the same time. Among 45 patients (mean age 55.9 years, range 32 to 82 years), twenty-six (57.8%) were female and the remaining nineteen were male. Non-hematological malignancy accounted for a major share (26.7%) in the underlying disease.
CONCLUSION
Antibody concurrence varied by BG antigenic specificity. Rh antibodies, in particular anti-E with anti-c appeared to be highly linked. Unlike in Western countries, anti-K was less common in Korea and so the pairs involving this antibody were scarce. More prospective investigations are needed to delineate the immunologic phenomenon of multiple alloimmunization.