血液病致ABO抗原减弱的血型基因定型研究

Genotyping for weakened ABO antigen expression caused by hematological diseases

目的探讨血清学定型出现ABO血型抗原减弱的血液病患者的基因分型,为临床输血提供血型依据。方法 2012年7月至2013年6月对320例血液病患者,采用血型血清学方法进行ABO血型鉴定,并对ABO血型抗原减弱的标本采用聚合酶链反应-序列特异性引物法(PCR-SSP)进行基因分型。结果 53例试管法正反定型相符,可确定ABO血型;210例反定型抗体减弱或异常;57例抗原减弱。57例抗原减弱患者中,急性髓细胞白血病(AML)35例,骨髓增生异常综合征(MDS)12例,再生障碍性贫血(AA)3例,慢性粒细胞白血病(CML)和急性淋巴细胞白血病(ALL)各2例,慢性淋巴细胞白血病(CLL)、淋巴瘤、特发性血小板减少性紫癜(ITP)各1例。经基因分型,57例患者中A抗原减弱23例,确定A型血,B抗原减弱26例,确定B型血,A、B抗原均减弱8例,确定AB型血。结论 ABO血型抗原减弱最多见于AML和MDS患者,进行血型基因检测可明确ABO血型。ABO抗原减弱时经基因分型确定血型后,输血时可同型输血。

Objective To perform genotyping for patients with hematological diseases who had weakened ABO antigen expression and to provide evidence for clinical transfusion. Methods Between July 2012 and June 2013, routine serologic typing were performed for 320 patients with definite diagnosis of hematological diseases. Meanwhile, genotyping were carried by PCR-SSP technique in patients with weakened ABO expression. Results Among the 320 patients, ABO type of 53 patients were determined by tube test; 210 patients were identified with weak or abnormal antibody level when performing reverse ABO grouping; 57 samples were detected weakened ABO antigen expression. Among these 57 patients, 35 were acute myeloid leukemia （AML）, 12 were myeloid dysplasia syndrome （MDS）, 3 were aplastic anemia （AA）, 2 were chronic myelocytic leukemia （CML）, 2 were acute lymphocytic leukemia （ALL）, 1 was chronic lymphocytic leukemia （CLL）, 1 was lymphoma, and 1 was idiopathic thrombocytopenic purpura （ITP）. Conclusion Weakened ABO antigen expression is most often occurred in patients with AML and MDS. ABO types can further clarified by genotyping. Therefore, the pa-tients can receive ABO-identical blood transfusion, then, group O washed red blood cells, but group AB platelet/plasma is not recommended to be transfused.