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急性髓系白血病血型变化及其与治疗效果的关系

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目的 探究 2 名血型正反定型不符且疑似O型的急性髓系白血病患者血型变化,及其与疾病治疗效果的关系。方法 血型鉴定使用微柱凝胶法、试管法、吸收放散试验对患者ABO血型做血型血清学分析;微流控芯片法检测ABO的血型基因分型,采用PCR法扩增ABO基因外显子E2~E7,扩增产物用Sanger法进行基因测序。结果 2 例的常规血型血清学检测结果,均为正定O型,反定A型,正反不符,吸收放散试验结果均有A抗原检出;2 例的ABO基因表型均为A型;基因分型结果分别为A102/A102;A102/O01,基因测序结果显示ABO血型基因SNP 位点分别为:467T/T;261G/delG、467C/T。其中 1 例,随着治疗的有效进展,与抗-A凝集反应强度出现明显地由弱到强的变化。结论 在临床中遇到正反定型不符且疑似O型的急性髓系白血病患者标本,我们应重视反定型结果的参考价值,须做吸收放散试验,并结合基因检测结果,做出正确的血型判断,为患者制定合适的输血策略。
Blood group changes in acute myeloid leukemia and their relationship with therapeutic effect
Objective To explore the blood group changes of two acute myeloid leukemia patients with suspected O type,and their relationship with the therapeutic effect.Methods Serological analysis of ABO blood group of patients was carried out by microcolumn gel method,tube method and absorption-elution test,ABO blood group genotyping was per-formed by microfluidic chip method.Exons E2 to E7 of ABO gene were amplified by PCR and sequenced by Sanger method.Results The forward typing of two cases were both O type,but the reverse typing were both A type.The absorption-elution test results all showed detection of antigen A.ABO gene phenotype of the two cases were both A,with genotyping results as A102/A102 and A102/O01,respectively.Sequencing results showed that SNP sites of ABO blood group were 467T/T,261G/delG and 467C/T,respectively.In one case,the intensity of anti-A agglutination reaction changed significantly from weak to strong with the progress of treatment.Conclusion For clinical samples of acute myeloid leukemia patients with ABO for-ward and reverse typing discrepancy and suspected O type,the result of reverse typing should be valued,and absorption-e-lution test should be performed to further confirm the ABO blood type combining the genetic test results,so as to develop ap-propriate blood transfusion strategies for patients.

forward and reverse typing discrepancyacute myeloid leukemiatherapeutic effectweakened antigenicity of the ABO blood groupgene sequencing

宋倩倩、杨爽、郝芊萌、张玉林

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郑州大学第二附属医院 输血科,河南 郑州 450000

正反定型不符 急性髓系白血病 治疗效果 ABO血型抗原减弱 基因测序

2024

中国输血杂志
中国输血协会 中国医学科学院输血研究所

中国输血杂志

CSTPCD
影响因子:1.279
ISSN:1004-549X
年,卷(期):2024.37(6)