Red blood cell alloimmunization in myelodysplastic syndromes: Associations with sex, DAT‐positivity, and increased transfusion needs

医学 危险系数 输血 泊松回归 比例危险模型 置信区间 内科学 红细胞 血红蛋白 回顾性队列研究 免疫学 入射(几何) 人口 环境卫生 光学 物理
作者
Jenny Rydén,Mark Clements,Agneta Wikman,Eva Hellström‐Lindberg,Gustaf Edgren,Petter Höglund
出处
期刊:Transfusion [Wiley]
卷期号:63 (11): 2040-2051
标识
DOI:10.1111/trf.17562
摘要

Abstract Background Many patients with myelodysplastic syndromes (MDS) need repeated red blood cell transfusions which entails a risk of immunization and antibody formation. Associations between alloantibodies, autoantibodies and increased transfusion requirements have been reported, but their relationship remains unclear. In this study, we analyzed factors potentially associated with red blood cell alloimmunization, as well as changes in transfusion intensity and post‐transfusion hemoglobin increments. Methods In a retrospective cohort study, we linked Swedish MDS patients diagnosed between 2003 and 2017 to transfusion and immunohematology data. Potentially associated factors were analyzed using Cox proportional hazards regression. The transfusion rate after detected alloimmunization was analyzed using a fixed effects Poisson regression. Post‐transfusion hemoglobin increments before and after alloimmunization were compared using a mixed effects regression. Results Alloantibodies following MDS diagnosis were detected in 50 out of 429 patients (11.7%). Female sex and a positive direct antiglobulin test (DAT) were independently associated with alloimmunization, with hazard ratios of 2.02 (95% confidence interval [CI] 1.08–3.78) and 9.72 (95% CI, 5.31–17.74), respectively. The transfusion rate following alloimmunization was increased with an incidence rate ratio of 1.33 (95% CI, 0.98–1.80) and the post‐transfusion hemoglobin increment after alloimmunization was 1.40 g/L (95% CI, 0.52–2.28) lower per red blood cell unit ( p = .002) compared to before alloimmunization, in multivariable analyses. Discussion Alloimmunization against blood group antigens was associated with sex, DAT‐positivity, increased transfusion needs, and lower post‐transfusion hemoglobin increments. These findings warrant further investigation to evaluate the clinical significance of up‐front typing and prophylactic antigen matching in patients with MDS.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
完美麦片完成签到,获得积分10
3秒前
lll完成签到,获得积分10
4秒前
务实鞅完成签到 ,获得积分10
5秒前
量子星尘发布了新的文献求助10
10秒前
mawenyu完成签到,获得积分10
11秒前
17完成签到,获得积分20
11秒前
高大的水壶完成签到,获得积分10
12秒前
英俊的铭应助wellyou采纳,获得10
14秒前
风中的向卉完成签到 ,获得积分10
17秒前
Mp4完成签到 ,获得积分10
17秒前
凌兰完成签到 ,获得积分10
17秒前
plain完成签到,获得积分10
18秒前
陌上花开完成签到,获得积分10
19秒前
20秒前
fg2477完成签到,获得积分10
21秒前
忙碌的数学人完成签到,获得积分10
21秒前
情怀应助Engen采纳,获得10
21秒前
HJJHJH完成签到,获得积分10
23秒前
Bob发布了新的文献求助10
24秒前
25秒前
26秒前
HJJHJH发布了新的文献求助50
27秒前
JW完成签到,获得积分10
27秒前
wanci应助张参采纳,获得10
28秒前
谦让的西装完成签到 ,获得积分10
29秒前
李演员完成签到,获得积分10
30秒前
fei菲飞完成签到,获得积分10
30秒前
32秒前
Zhaowx完成签到,获得积分10
32秒前
Theprisoners完成签到,获得积分0
32秒前
木子发布了新的文献求助30
32秒前
32秒前
下课了吧完成签到,获得积分10
33秒前
丘比特应助xialuoke采纳,获得10
34秒前
zgt01发布了新的文献求助10
36秒前
linfordlu完成签到,获得积分0
36秒前
清浅发布了新的文献求助10
37秒前
风趣的涵柏完成签到,获得积分10
38秒前
40秒前
Chen完成签到 ,获得积分10
41秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038235
求助须知:如何正确求助?哪些是违规求助? 3575992
关于积分的说明 11374009
捐赠科研通 3305760
什么是DOI,文献DOI怎么找? 1819276
邀请新用户注册赠送积分活动 892662
科研通“疑难数据库(出版商)”最低求助积分说明 815022