Aloimunidade contra antígenos HLA de classe I em pacientes com síndromes mielodisplásicas e anemia aplástica

Arruda, Daisy Maria Meireles; Silva, Silvia F. R.; Silva, Sônia L.; Pitombeira, Maria Helena; Campos, Henry de Holanda; Mota, Rosa M. S.; Tg, Naidu

doi:10.1590/s1516-84842008000100007

Cited by 2 publications

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“…Leukocyte alloimmunization can have complications with considerable clinical impact on transfusion medicine and organ transplantation, including platelet transfusion refractoriness and humoral rejection, respectively ( 9 , 17 ) . In the present study, 30.5% of the patients presented leukocyte alloantibodies with greater alloreactivity to PRA among women (52.6 ± 28.2%) than men (23.0 ± 24.0%), possibly because of the greater number of transfusions received (5.6 ± 4.1 vs. 0 ± 2.9) and additional sensitization through gestations (1.2 ± 1.4 per woman).…”

Section: Discussionmentioning

confidence: 99%

“…Depending on the center and the population studied, the incidence of RBC and leukocyte alloimmunization is 2.5-76% and 20-65%, respectively ( 6 - 9 ) .…”

Section: Introductionmentioning

confidence: 99%

“…At each transfusion, the patient is exposed to new foreign antigens, eventually becoming alloimmunized against RBC antigens. Due to the presence of contaminating leukocytes in blood products, patients may also become sensitized to antigens of the human leukocyte antigen (HLA) system ( 9 , 10 ) . As a result, RBC alloimmunization may limit the availability of compatible blood for future transfusions, whereas the development of leukocyte alloimmunization often makes it necessary to postpone transplantation.…”

Section: Introductionmentioning

confidence: 99%

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Red blood cell and leukocyte alloimmunization in patients awaiting kidney transplantation

Silva

Ferreira

Silva

et al. 2013

Revista Brasileira De Hematologia E Hemoterapia

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Objective To determine the rates of red blood cell and leukocyte alloimmunization in patients with chronic kidney disease awaiting kidney transplantation. Methods In this cross-sectional and prospective study, the serum of 393 chronic kidney disease patients on a transplant waiting list in Ceará, Northeastern Brazil were tested for red cell and leukocyte antibodies. In addition, demographic, clinical and laboratory data were collected. Results The average age in the sample of 393 patients was 34.1 ± 14 years. Slightly more than half (208; 52.9%) were male. The average numbers of transfusions and gestations were 3.1 ± 3.3 and 1.6 ± 6, respectively. One third (33.6%) were alloimmunized: 78% with leukocyte antibodies, 9.1% with red cell antibodies and 12.9% with both. Red cell antibodies were detected in 29 cases (7.4%), 17 of whom were women, who had received more transfusions than the males (p-value < 0.0001). The most frequently detected red cell antibodies belonged to the Rh (24.1%) and Kell (13.8%) blood group systems. Leukocyte antibodies were detected in 30.5% of cases, 83 of whom were women, who had received more transfusions than the males (p-value < 0.0001) and were more reactive to panel reactive antibodies (p-value < 0.0001). The mean alloreactivity to panel reactive antibodies was 47.7 ± 31.2%. Conclusion Chronic kidney disease patients on the transplant waiting list in Ceará, Brazil, display high rates of red cell (7.4%) and leukocyte (30.5%) alloimmunization. In this sample, alloimmunization was significantly associated with the number of transfusions and gender.

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Section: Discussionmentioning

confidence: 99%

“…Depending on the center and the population studied, the incidence of RBC and leukocyte alloimmunization is 2.5-76% and 20-65%, respectively ( 6 - 9 ) .…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Red blood cell and leukocyte alloimmunization in patients awaiting kidney transplantation

Silva

Ferreira

Silva

et al. 2013

Revista Brasileira De Hematologia E Hemoterapia

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“…21 Na avaliação da aloimunidade contra antígenos HLA de classe I em pacientes com SMD, a produção de anticorpos pode trazer sérias complicações para esses pacientes, requerendo avaliações sistemáticas para detecção de anticorpos anti-HLA após a reposição transfusional, a fim de estabelecer uma terapia sem formação de auto-anticorpos e isenta de riscos. 29 Após discutir a doença e estabelecer o IPSS como fator prognóstico a ser levado em consideração, o Transplante de célula-tronco hematopoética (TCTH) deve ser considerado em pacientes com menos de 60 anos, com doador familiar HLA-idêntico. Apesar de alto risco de recaída, as taxas de mortalidade associada ao procedimento são menores.…”

Section:  Estudos Sobre Tratamentounclassified

The scientific production on myelodysplastic syndromes: a systematic review

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Ivo

2011

Rev enferm UFPE on line.

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Objective: to map the brazilian scientific production on myelodysplastic syndromes (MDS) in order to highlight points for investigation. Method: this is a literature review study carried out through electronic search in indexed databases, between October 2010 and January 2011. Papers on myelodysplastic syndromes published in Brazil were surveyed, indexed in the databases available in the site of Biblioteca Virtual em Saúde. The databases used in the survey were the Medical Literature Analysis and Retrieval System Online (MEDLINE), Latin-American and Caribbean Literature on Health Sciences Information (LILACS), Integrated Building Environmental Communications System (IBECS), and Scientific Electronic Library Online (SciELO Brasil). Results: the final sample involved 32 full papers. Through systematic reading, five categories of analysis were identified: the (1) diagnostic and (2) prognosis studies show the beginning of MDS classifications based on analysis of peripheral blood, myelogram, and bone marrow biopsy, combined with clinical evaluation of patients. The (3) treatment remains supportive for most patients. Few (4) case studies have been carried out, with no conclusive correlations. The (5) reviews brought significant guidelines for the management of patients. Conclusion: there is a need for clinical trials in larger populations, in order to gain power of generalization of results, as well as to find the epidemiological characterization of the Brazilian myelodysplastic population. Descriptors: preleukemia; refractory anemia; refractory anemia with excessive blasts.ResumoObjetivo: mapear a produção científica brasileira sobre síndromes mielodisplásicas (SMD), a fim de evidenciar pontos para investigação. Método: trata-se de estudo de revisão de literatura, realizado por meio de busca eletrônica em bases de dados indexadas, entre os meses de outubro de 2010 e janeiro de 2011. Foram rastreados artigos publicados sobre síndromes mielodisplásicas no Brasil, indexados nas bases de dados da Biblioteca Virtual em Saúde: Medical Literature Analysis and Retrieval System Online (MEDLINE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Integrated Building Environmental Communications System (IBECS) e Scientific Electronic Library Online (SciELO Brasil). Resultados: a amostra foi composta por 32 trabalhos completos. Por meio de leitura sistemática, foram identificadas cinco categorias de análise: os (1) estudos de diagnóstico e de (2) prognóstico evidenciam o início das classificações de SMD baseadas na análise do sangue periférico, mielograma e biópsia de medula óssea, aliados à avaliação clínica dos pacientes. O (3) tratamento continua sendo de suporte para a maior parte dos pacientes. Poucos (4) estudos de casos foram realizados, sem correlações conclusivas. As (5) revisões trouxeram significativas orientações para o manejo dos pacientes. Conclusão: há necessidade de estudos com ensaios clínicos em populações maiores, de forma a se obter poder de generalização dos resultados, bem como caracterização epidemiológica da população mielodisplásicas brasileira. Descritores: pré-leucemia; anemia refratária; anemia refratária com excesso de blastos.RESUMENObjetivo: mapear la producción científica brasileña sobre los síndromes mielodisplásicos (SMD), a fin de evidenciar puntos para investigación. Método: esto es un estudio de revisión de literatura realizado por medio de búsqueda electrónica en bases de datos indexadas, entre los meses de octubre de 2010 y enero de 2011. Fueron rastreados artículos publicados sobre síndromes mielodisplásicos en Brasil, indexados en las bases de datos disponibles en el site de la Biblioteca Virtual em Saúde. Las bases de datos usadas en la encuesta fueron la Medical Literature Analysis and Retrieval System Online (MEDLINE), Literatura Latinoamericana y del Caribe de Información en Ciencias de la Salud (LILACS), Integrated Building Environmental Communications System (IBECS) y Scientific Electronic Library Online (SciELO Brasil). Resultados: la muestra final incluyó 32 trabajos completos. Por medio de lectura sistemática, se identificaron cinco categorías de análisis: los (1) estudios de diagnóstico y de (2) pronóstico muestran el inicio de las clasificaciones de SMD basados en el análisis de la sangre periférica, mielograma y biopsia de médula ósea, junto con la evaluación clínica de los pacientes. El (3) tratamiento sigue siendo de suporte para la mayoría de los pacientes. Pocos (4) estudios de caso fueron llevados a cabo, sin correlaciones concluyentes. Las (5) revisiones trajeron directrices significativas para el manejo de los pacientes. Conclusión: hay necesidad de estudios con ensayos clínicos en poblaciones más grandes, con el fin de obtener poder de generalización de los resultados, así como caracterización epidemiológica de la población mielodisplásica brasileña. Descriptores: preleucemia; anemia refractaria; anemia refractaria con exceso de blastos.

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Aloimunidade contra antígenos HLA de classe I em pacientes com síndromes mielodisplásicas e anemia aplástica

Cited by 2 publications

References 7 publications

Red blood cell and leukocyte alloimmunization in patients awaiting kidney transplantation

Red blood cell and leukocyte alloimmunization in patients awaiting kidney transplantation

The scientific production on myelodysplastic syndromes: a systematic review

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