Anti-AnWj antibody in a case with non-Hodgkin lymphoma

Anti‐AnWj causing acute hemolytic transfusion reactions in a patient with aplastic anemia

“…None of the family members had received transfusions. All other reported cases of anti‐AnWj have occurred in patients with underlying immune dysregulation, including lymphoid malignancies (Waldenström's macroglobulimenia, Hodgkin's disease, and non‐Hodgkin's lymphoma), systemic lupus erythematosus, autoimmune hemolytic anemia, and a poorly characterized neurologic disorder 2,4‐10 . Our patient, with underlying autoimmune neutropenia evolving into aplastic anemia, and no history of consanguinity, clearly fits in this second category 18,19 .…”

“…The likely immunizing event in these cases was pregnancy, although the antibody was not associated with hemolytic disease of the fetus and newborn (HDFN). In several other cases, anti‐AnWj was found in patients with lymphoid malignancies, immunologic disorders, or autoimmune hemolytic anemia and thought to result from transient suppression of the AnWj antigen on the patient's own red blood cells (RBCs) 2,4‐10 . As is the case for all patients with antibodies against a high‐prevalence antigen, provision of transfusion support for a patient with anti‐AnWj poses a significant challenge 11 …”

“…Hence, for patients requiring multiple transfusions, use of In(Lu)‐type Lu(a−b−) units or random AnWj‐positive units may be necessary. Variable clinical outcomes have been reported in patients with anti‐AnWj transfused with AnWj‐positive RBCs, ranging from acute symptomatic hemolysis to normal RBC increments with no symptoms or signs of hemolysis 2‐10 …”

SMYD1 is the underlying gene for the AnWj‐negative blood group phenotype

“…Antibodies to AnWj are extremely rare; in some individuals’ transient suppression of the AnWj antigen on the patient's own RBCs results in the formation of anti‐AnWj. Such events were reported in association with lymphoid malignancies, immunologic disorders, and autoimmune hemolytic anemia . The level of anti‐AnWj decreased considerably or disappeared after treating the underlying condition or following immunosuppressive therapy.…”

“…Such events were reported in association with lymphoid malignancies, immunologic disorders, and autoimmune hemolytic anemia. [5][6][7][8][9][10] The level of anti-AnWj decreased considerably or disappeared after treating the underlying condition or following immunosuppressive therapy. Anti-AnWj antibodies can also develop in rare individuals who have an inherited AnWj-negative phenotype.…”