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RH genotyping in a sickle cell disease patient contributing to hematopoietic stem cell transplantation donor selection and management.


ABSTRACT: African individuals harbor molecular RH variants, which permit alloantibody formation to high-prevalence Rh antigens after transfusions. Genotyping identifies such RH variants, which are often missed by serologic blood group typing. Comprehensive molecular blood group analysis using 3 genotyping platforms, nucleotide sequencing, and serologic evaluation was performed on a 7-year-old African male with sickle cell disease who developed an "e-like" antibody shortly after initiating monthly red blood cell (RBC) transfusions for silent stroke. Genotyping of the RH variant predicted a severe shortage of compatible RBCs for long-term transfusion support, which contributed to the decision for hematopoetic stem cell transplantation. RH genotyping confirmed the RH variant in the human leukocyte antigen-matched sibling donor. The patient's (C)ce(s) type 1 haplotype occurs in up to 11% of African American sickle cell disease patients; however, haplotype-matched RBCs were serologically incompatible. This case documents that blood unit selection should be based on genotype rather than one matching haplotype.

SUBMITTER: Fasano RM 

PROVIDER: S-EPMC2974591 | biostudies-literature | 2010 Oct

REPOSITORIES: biostudies-literature

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RH genotyping in a sickle cell disease patient contributing to hematopoietic stem cell transplantation donor selection and management.

Fasano Ross M RM   Monaco Alessandro A   Meier Emily Riehm ER   Pary Philippe P   Lee-Stroka A Hallie AH   Otridge John J   Klein Harvey G HG   Marincola Francesco M FM   Kamani Naynesh R NR   Luban Naomi L C NL   Stroncek David D   Flegel Willy A WA  

Blood 20100719 15


African individuals harbor molecular RH variants, which permit alloantibody formation to high-prevalence Rh antigens after transfusions. Genotyping identifies such RH variants, which are often missed by serologic blood group typing. Comprehensive molecular blood group analysis using 3 genotyping platforms, nucleotide sequencing, and serologic evaluation was performed on a 7-year-old African male with sickle cell disease who developed an "e-like" antibody shortly after initiating monthly red bloo  ...[more]

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