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Diminished expression of B antigen mimicking B3 phenotype in a patient with AML-M3: a rare case report

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The ABO blood group system plays an important role in transfusion and transplantation practices... Incubation of the forward grouping tubes at 4 °C showed 3+/mf agglutination reaction with anti-B and anti-A,B antisera while reverse grouping results remained the same... Repeat blood grouping was carried out by the tube technique with another fresh sample and it was found to be no different to the previous results... The amino acid substitutions within exon 7 determine whether glycosyltransferase will use UDP-N-acetyl-d-galactosamine (A transferase) or UDP-d-galactose (B transferase) donor sugars to synthesize A or B antigens, respectively... The nucleotide deletion in exon 6 that results in the inactive enzyme is characteristic of O alleles... Diminished expression of ABH antigens can occur with variant ABO alleles and in hematological disorders such as leukemia, myeloproliferative disorders, myelodysplastic syndrome and in some cases of Hodgkin's lymphoma... It has also been found in healthy elderly adults, pregnant females and neonates., , Myeloid neoplasms have been reported to be more frequently associated with ABH antigenic alterations than lymphoid malignancies... Our patient had no such history... Mixed field reactions can also be observed in hematological malignancies (particularly myeloid leukemia) where a varying proportion of red blood cells do not agglutinate., Weakened expression of the A antigen on red cells mimicking the A3 phenotype was reported by Salmon et al. in patients with leukemia... There may be qualitative (difference in the ability to bind the antibody) as well as quantitative (number of antigens on red blood cells) differences in the B antigen of B3 red cells from normal B cells... It is safe to transfuse O group red cells in a patient with red blood cells expressing a variant ABO... Weak subgroups of the ABO blood group system are hardly reported in the day-to-day practice... Early recognition of the loss of ABH antigens is extremely important because it may indicate underlying sinistrous pre-leukemic states... In patients with hematological malignancies, correct ABO blood grouping is important as they require multiple transfusions and often undergo hematopoietic stem cell transplantation.

No MeSH data available.


Results of forward blood grouping by column agglutination technology showing mixed field agglutination with anti-B.
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fig0005: Results of forward blood grouping by column agglutination technology showing mixed field agglutination with anti-B.

Mentions: Forward grouping using the tube technique showed mixed field appearance with anti-B and anti-A,B antisera. Incubation of the forward grouping tubes at 4 °C showed 3+/mf agglutination reaction with anti-B and anti-A,B antisera while reverse grouping results remained the same. Repeat blood grouping was carried out by the tube technique with another fresh sample and it was found to be no different to the previous results. Results were confirmed by column agglutination technology (ORTHO BioVue™, Ortho Clinical Diagnostics, USA) (Figure 1). His blood group was B Rh D positive as per his previous records.


Diminished expression of B antigen mimicking B3 phenotype in a patient with AML-M3: a rare case report
Results of forward blood grouping by column agglutination technology showing mixed field agglutination with anti-B.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4997902&req=5

fig0005: Results of forward blood grouping by column agglutination technology showing mixed field agglutination with anti-B.
Mentions: Forward grouping using the tube technique showed mixed field appearance with anti-B and anti-A,B antisera. Incubation of the forward grouping tubes at 4 °C showed 3+/mf agglutination reaction with anti-B and anti-A,B antisera while reverse grouping results remained the same. Repeat blood grouping was carried out by the tube technique with another fresh sample and it was found to be no different to the previous results. Results were confirmed by column agglutination technology (ORTHO BioVue™, Ortho Clinical Diagnostics, USA) (Figure 1). His blood group was B Rh D positive as per his previous records.

View Article: PubMed Central - PubMed

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

The ABO blood group system plays an important role in transfusion and transplantation practices... Incubation of the forward grouping tubes at 4 °C showed 3+/mf agglutination reaction with anti-B and anti-A,B antisera while reverse grouping results remained the same... Repeat blood grouping was carried out by the tube technique with another fresh sample and it was found to be no different to the previous results... The amino acid substitutions within exon 7 determine whether glycosyltransferase will use UDP-N-acetyl-d-galactosamine (A transferase) or UDP-d-galactose (B transferase) donor sugars to synthesize A or B antigens, respectively... The nucleotide deletion in exon 6 that results in the inactive enzyme is characteristic of O alleles... Diminished expression of ABH antigens can occur with variant ABO alleles and in hematological disorders such as leukemia, myeloproliferative disorders, myelodysplastic syndrome and in some cases of Hodgkin's lymphoma... It has also been found in healthy elderly adults, pregnant females and neonates., , Myeloid neoplasms have been reported to be more frequently associated with ABH antigenic alterations than lymphoid malignancies... Our patient had no such history... Mixed field reactions can also be observed in hematological malignancies (particularly myeloid leukemia) where a varying proportion of red blood cells do not agglutinate., Weakened expression of the A antigen on red cells mimicking the A3 phenotype was reported by Salmon et al. in patients with leukemia... There may be qualitative (difference in the ability to bind the antibody) as well as quantitative (number of antigens on red blood cells) differences in the B antigen of B3 red cells from normal B cells... It is safe to transfuse O group red cells in a patient with red blood cells expressing a variant ABO... Weak subgroups of the ABO blood group system are hardly reported in the day-to-day practice... Early recognition of the loss of ABH antigens is extremely important because it may indicate underlying sinistrous pre-leukemic states... In patients with hematological malignancies, correct ABO blood grouping is important as they require multiple transfusions and often undergo hematopoietic stem cell transplantation.

No MeSH data available.