Analysis and treatment of blood diseases caused-weakenABOantigen
LI Yunyan2, ZHAO Guosheng3, LIU Fengxia3, QU Lin1
1. Department of Clinical Laboratory, Third Xiangya Hospital, Central South University, Changsha 410013, China; 2. 921st Hospital of the Joint Service and Security Force of the Chinese People's Liberation Army, Changsha 410003, China; 3. Department of Blood Transfusion, the Third Xiangya Hospital, Central SouthUniversity, Changsha 410013, China
Abstract:Objective To explore the main causes of ABO blood group antigen reduction in patients with diseases and the method of blood group serological identification. Methods ABO blood group serological identification was performed on clinical specimens to be tested by automatic blood group analyzer. Blood samples of patients with positive and negative ABO type agglutination intensity < 3+ and negative ABO type agglutination intensity <2+ were identified by classical test tube method, such as ABO positive and negative stereotyping, saliva test, absorption and release test, affinity test and other blood group serological tests. the samples were genotyped by PCR-SSP genotyping assay kit; and exons 1-7 of the ABO gene were sequenced to confirm the mutation sites. Results Among 67 patients with ABO blood group antigen weakened due to disease, there were 30 patients with leukemia (44.7%), 26 patients with hematological diseases (38.9%), 9 patients with myelodyspllastic syndrome(MDS) (13.4%), 1 patient with non-Hodgkin lymphoma (1.5%), and 1 patient with chronic osteomyelitis (1.5%).43 cases (64.2%) with A antigen weakened, 23 cases (34.3%) with B antigen weakened, and 1 case (1.5%) with AB antigen weakened. There were 2 cases (2.98%) with enhanced H antigen, and the other intensities were unchanged. PCR-SSP genotyping and sequencing of exons 1-7 of theABOgene identified some new mutation sites, including 607G>A, 734C>T in exon 7, 259G>T, 261delG in exon 6, 239G>A in exon 5, and 18insTTGCA in exon 1. Conclusion Leukemia is the main cause ofABOblood group antigen weakening. By comprehensive analysis of clinical data and using blood group serology,ABO blood group can be distinguished from ABO subtype and correctly identified to ensure the safety of clinical transfusion.
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