Rh-negative volunteers were given an injection of 1 ml of Rh-positive red cells, either alone or with 15 μg or 75 μg anti-D. Six months later anti-Rh was detected in 2 out of 14 subjects who had originally received Rh-positive red cells alone but in none out of 8 subjects who had also received 15 μg anti-D and in none out of 15 subjects who had also received 75 μg anti-D. Six months after the start of the experiment, thirty-four of the subjects were injected with 1 ml of ^51Cr labelled red cells without anti-D. At 7—11 days after injection, survival was normal in all of 13 subjects who had received 75 μg anti-D with their first injection of red cells. By contrast, survival was subnormal in seven out of 13 cases who had received no anti-D with their first injection of red cells. This difference is significant (p = 0.027) and is taken to indicate that primary immunization occurred when 1 ml of Rh-positive red cells was given alone but was prevented when 1 ml of red cells was given with 75 μg anti-D. Survival at 7 days was slightly subnormal in 2 out of 8 subjects who had received 15 μg anti-D with their first injection of red cells; this is taken as evidence that no augmentation of primary immunization was produced with this dose. In a follow-up study of another series of Rh-negative volunteers, who had been injected with 0.3 ml of Rh-positive red cells at a time when they had between 0.6 and 4 fig anti-D in their circulation, 3 to 8 months later the survival of injected Rh-positive red cells was normal in 5 out of 6 cases, suggesting that there had been no augmentation of primary immunization.
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