Kazan medical journalKazan medical journal0368-48142587-9359Eco-Vector7731810.17816/KMJ2021-621Research ArticleBlood group genotyping in multi-transfused patientsMineevaN Vizoserologia@mail.ruhttps://orcid.org/0000-0001-7137-8877KrobinetsI Itransfusion_spb@mail.ruhttps://orcid.org/0000-0002-6404-2387GavrovskayaS Vizoserologia@mail.ruBodrovaN Nizoserologia@mail.ruSisoevaE Aizoserologia@mail.ruhttps://orcid.org/0000-0002-9465-4704ChechetkinA Vbloodscience@mail.ruhttps://orcid.org/0000-0002-7569-0697BessmeltsevS Sbessmeltsev@yandex.ruhttps://orcid.org/0000-0001-7280-7100Russian Research Institute of Hematology and Transfusiology Federal medical biological agency1310202110256216250408202122092021Copyright © 2021, Eco-Vector2021<p><strong>Aim.</strong> To assess the possibility of using blood group genotyping in recipients who received transfusions for 3 months.</p>
<p><strong>Methods.</strong> The study included blood samples from 95 patients who received 3 or more erythrocyte transfusions within 3 months. The patients had the following diagnoses: multiple myeloma (n=7), beta thalassemia (n=4), non-Hodgkin's lymphomas (n=11), chronic myeloid leukemia (n=16), primary myelofibrosis (n=9), myelodysplastic syndrome (n=22), acute leukemia (n=21), aplastic anemia (n=5). Red blood cells phenotyping was performed in Diaclon Rh Subgroups+K Gel Cards. The Rh and Kell genotyping was performed by using RBC SSP-PCR kits FluoGene vERYfy (Inno-train Diagnostics, Germany). The standard RHD/RHCE alleles, as well as polymorphisms associated with KEL1/KEL2 [T698C (Met198Thr)] of the KEL gene were genotyped.</p>
<p><strong>Results.</strong> The concordance rate between serological and molecular genetic typing of RhCE and Kell blood groups for donors was 100%, while the patients results were discordant in 45.3% of cases. Discrepancies in antigens of the Rh system were registered in 41 patients: one antigen of the Rh system in 30 patients, two in 9 patients. Ten patients who had been previously phenotyped as RhCc were genotyped as RHCE*CC. 2 patients who had been previously phenotyped as Rhee were genotyped as RHCE*EE. In 2 patients, antigens D and C were not detected in the phenotype but were identified in the genotype. Discrepancies in antigen K were recorded in 2 patients, and the antigen was absent in the phenotype but was present in the genotype. The genotyping results were confirmed by serological typing at subsequent hospitalizations.</p>
<p><strong>Сonclusion.</strong> Blood group genotyping is a useful adjunct to traditional methods when serological typing is limited.</p>RHCE and Kell blood group systemsblood group genotypinghematological diseasesmulti-transfused patientsdonorsсистемы антигенов эритроцитов Rh и Kellгенотипирование групп крови эритроцитовгематологические заболеваниямножественные трансфузиидоноры[Anstee D.J. Red cell genotyping and future of pretransfusion testing. Blood. 2009; 114: 248–256. DOI: 10.1182/blood-2008-11-146860.][Reid M.E. Transfusion in the age of molecular diagnostics. Hematology. 2009; 14: 171–177. DOI: 10.1182/asheducation-2009.1.171.][Scharberg E.A., Richter E. Red cell antigen testing. ISBT Sci. Series. 2015; 10: 5–11. DOI: 10.1111/voxs.12134.][Nambiar R.K., Narayanan G., Prakash N.P., Vijayalakshmi K. Blood group change in acute myeloid leukemia. Proceedings (Baylor University. Medical Center). 2017; 30: 74–75. DOI: 10.1080/08998280.2017.11929536.][Chapuy C.I., Nicholson R.T., Aguad M.D., Chapuy B., Laubach J.P., Richardson P.G., Doshi P., Kaufman R.M. Resolving the daratumumab interference with blood compatibility testing. Transfusion. 2015; 55: 1545–1554. DOI: 10.1111/trf.13069.][Krobinets I.I., Mineeva N.V., Sysoeva E.A., Chechetkin A.V. Features of interpretation of the results of studies of AB0 and Rhesus antigens and antibodies in patients with hematological diseases. Sibirskiy nauchnyy meditsinskiy zhurnal. 2020; 40 (5): 66–72. (In Russ.) DOI: 10.15372/SSMJ20200507.][Bakanay S.M., Ozturk A., Ileri T., Ince E., Yavasoglu S., Akar N., Uysal Z., Arslan O. Blood group genotyping in multi-transfused patients. Transfusion and Apheresis Sci. 2013; 48: 257–261. DOI: 110.1016/j.transci.2013.01.009.][Butina E.V., Meneeva N.V., Zaitseva G.A., Poponina E.A., Yovdiy A.V. Red blood cell alloimmunization in patients with hematology/oncology disorders. Transfuziologiya. 2019; 21 (2): 27–34. (In Russ.)][Wang L.Y., Liang D.C., Liu H.C., Chang F.C., Wang C.L., Chan Y.S., Lin M. Alloimmunization among patients with transfusion-dependent thalassemia in Taiwan. Transfus. Med. 2006; 16: 200–203. DOI: 10.1111/j.1365-3148.2006.00656.x.][Karimi M., Nikrooz P., Kashef S., Jamalian N., Davatolhagh Z. RBC alloimmunization in blood transfusion-dependent beta-thalassemia patients in southern Iran. Int. J. Lab. Hematol. 2007; 29: 321–326. DOI: 10.1111/j.1365-2257.2006.00856.x.][Mineeva N.V., Pashkova I.A., Krobinets I.I., Sysoeva E.A. Allosensibilisation to erythrocyte antigens. Onkogematologiya. 2015; 10 (4): 60–65. (In Russ.) DOI: 10.17650/1818-8346-2015-10-4-60-65.][Kalandarov R.S., Golovkina L.L., Vasilieva M.N., Stremouchova A.G., Pushkina T.D., Atroshchenko G.V., Parovichnikova E.N. Genotyping of AB0 and Rh systems blood groups in patients after multiple hemotransfusions. Onkogematologiya. 2017; 12 (2): 70–79. (In Russ.) DOI: 10.17650/1818-8346-2017-12-2-70-79.][Belsito A., Costa D., Fioritoet C., De Iorio G., Casamassimi A., Perrotta S., Napoli C. Erythrocyte genotyping for transfusion-dependent patients at the Azienda Universitaria Policlinico of Naples. Transfusion and Apheresis Sci. 2015; 52: 72–77. DOI: 10.1016/j.transci.2014.12.006.][Castilho L., Rios M., Bianco C., Pellegrino J.Jr., Alberto F.L., Saad S.T.O., Costa F.F. DNA-based typing of blood groups for the management of multiply-transfused sickle cell disease patients. Transfusion. 2002; 42: 232–238. DOI: 10.1046/j.1537-2995.2002.00029.x.][Remeikiene D., Ugenskiene R., Inciura A., Savukaityte A., Raulinaityte D., Skrodeniene E., Simoliuniene R., Juozaityte E. Duffy and Kidd genotyping facilitates pretransfusion testing in patients undergoing long-term transfusion therapy. Turk. J. Haematol. 2014; 31: 367–373. DOI: 10.4274/tjh.2013.0075.][Rujirojindakul P., Flegel W.A. Applying molecular immunohaematology to regularly transfused thalassaemic patients in Thailand. Blood Transfus. 2014; 12: 28–35.][Legler T.G., Eber S.W., Lakomek M., Lynen R., Maas J.H., Pekrun A., Repas-Humpe M., Schröter W., Köhler M. Application of RHD and RHCE genotyping for correct blood group determination in chronically transfused patients. Transfusion. 1999; 39: 852–855. DOI: 10.1046/j.1537-2995.1999.39080852.x.][Kulkarni S., Choudhary B., Gogri H., Patil S., Manglani M., Sharma R., Madkaikar M. Molecular genotyping of clinically important blood group antigens in patients with thalassemia. Indian J. Med. Res. 2018; 148: 713–720. DOI: 10.4103/ijmr.IJMR_455_17.][Bessmeltsev S.S., Romanenko N.A. Anemiya pri opukholevykh zabolevaniyakh sistemy krovi. Rukovodstvo dlya vrachey. (Anemia in tumor diseases of the blood system. Hands for doctors.) M.: SIMK. 2017; 228 p. (In Russ.)]