分子生物学鉴定急性白血病患者ABO血型抗原

Molecular genetic analysis of ABO blood group antigens of a patient with acute leukemia

目的:应用分子生物学方法鉴定急性白血病患者ABO血型抗原,确定患者ABO血型正反定型不符的原因。方法:选取临床正反定型不一致白血病患者,常规血清学ABO血型正反定型;直接和间接抗人球蛋白试验检测不规则抗体;吸收放散法鉴定弱血型抗原;PCR方法扩增ABO基因的7个外显子及侧翼内含子,扩增产物进行测序及序列分析。结果:患者正定型为AB亚型,反定型为AB型;直抗和间抗为阴性;吸收放散试验证明红细胞上存在弱A和B抗原;ABO基因扩增产物测序结果表明其基因型为ABO*A102/B101。结论:该白血病患者经分子生物学方法确定为正常AB型,其血型抗原减弱由白血病所致。基因分型法可以正确区分血型抗原减弱或亚型。

Objective：To indentify ABO blood group antigen by genotyping,and explore the mechanism of ABO discrepancy in a patient due to acute leukemia.Method：A acute myeloid leukemia patient with ABO typing discrepancy was selected.Routine serological test was carried out to analyze ABO blood group.Both direct and indirect anti-globulin tests were performed to screen irregular antibodies.The presence of the blood group determinants on the red blood cells were determined by adsorption-elution test.Exons 1-7and adjacent introns of the ABO gene were amplified by PCR and sequenced.Result：ABO forward typing indicated that the patient was AB subgroup.However the reverse typing defined AB.Direct and indirect anti-globulin tests were negative.The RBCs could adsorb anti-A and anti-B,which were able to be eluted subsequently.ABO genotyping was ABO＊A102/B101.Conclusion：The leukemia patient with ABO discrepancy by serological test was defined as AB by molecular genetic analysis.The suppressed expressions of A and B antigens on RBCs were due to acute myeloid leukemia.The genotyping could be used to differentiate the subgroup and suppressed expressions of blood group antigens.