Red blood cell transfusion in warm-type autoimmune haemolytic anaemia

Salama, Abdulgabar; Berghöfer, Heike; Mueller‐Eckhardt, C.

doi:10.1016/0140-6736(92)92766-9

Cited by 82 publications

(43 citation statements)

References 10 publications

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“…DIA, which can be the result of drug-hapten antibodies or drug-independent autoantibodies, is treated much the same way, with discontinuance of the offending drug and, much more often than in AIHA, performance of blood transfusions (15,16). A subsequent limitation of repeated transfusions of packed RBCs is that although they revive tissue perfusion, they carry the risks of hemolytic transfusion reactions, the formation of alloantibodies, and iron toxicity (17)(18)(19).…”

mentioning

confidence: 99%

Clearance of pathological antibodies using biomimetic nanoparticles

Copp¹,

Fang²,

Luk³

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

246

183

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Pathological antibodies have been demonstrated to play a key role in type II immune hypersensitivity reactions, resulting in the destruction of healthy tissues and leading to considerable morbidity for the patient. Unfortunately, current treatments present significant iatrogenic risk while still falling short for many patients in achieving clinical remission. In the present work, we explored the capability of target cell membrane-coated nanoparticles to abrogate the effect of pathological antibodies in an effort to minimize disease burden, without the need for drug-based immune suppression. Inspired by antibody-driven pathology, we used intact RBC membranes stabilized by biodegradable polymeric nanoparticle cores to serve as an alternative target for pathological antibodies in an antibody-induced anemia disease model. Through both in vitro and in vivo studies, we demonstrated efficacy of RBC membrane-cloaked nanoparticles to bind and neutralize anti-RBC polyclonal IgG effectively, and thus preserve circulating RBCs.nanomedicine | immune therapy | type II hypersensitivity reaction | autoantibody

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mentioning

confidence: 99%

Clearance of pathological antibodies using biomimetic nanoparticles

Copp¹,

Fang²,

Luk³

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

246

183

View full text Add to dashboard Cite

show abstract

“…In fact, the destruction of allogeneic red blood cells by autoantibodies is not stronger than their own red blood cells. In other words, the autoantibodies do not aggravate the patient's hemolytic anemia because of allogeneic transfusion, and allogeneic transfusion still benefits patients (Salama et al, 1992;Garratty and Petz, 1993;Petz and Garratty, 2004). However, there is a serological characteristic in patients with WAIHA that needs attention.…”

Section: Discussionmentioning

confidence: 99%

Effect of superposition and masking between red blood cell autoantibodies and alloantibodies

Wang

2014

Genet. Mol. Res.

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ABSTRACT. This study aimed to explore the law of superposition and masking between autoantibodies and alloantibodies, and to ensure the detection of alloantibodies and to improve the safety of warm autoimmune hemolytic anemia patients. Eight kinds of commercial IgG red blood cell antibody reagents were serially diluted, and 3 kinds of antibodies at dilutions showing a continuous gradual decline in agglutination strength with the corresponding antigen red blood cells were treated as the target antibodies. Anti-D and anti-M were treated as simulated autoantibodies, and anti-Fy a was treated as a simulated alloantibody. Four concentrations, 4+, 3+, 2+ and 1+, of autoantibodies and three concentrations, 3+, 2+ and 1+, of alloantibodies were combined, and 12 kinds of hybrid antibodies were detected and evaluated by the anti-human globulin micro-column gel assay. When the simulated strong autoantibody (4+) was used, the alloantibodies (3+, 2+, 1+) had no effect on the final agglutination strength; when the strength of agglutination produced by the simulated autoantibody was less than 4+, and at the same time there were alloantibodies (3+, 2+, 1+), the differences in agglutination strength with a panel of RBCs could be clearly observed. Strong autoantibodies (4+) can exert a masking effect, leading to alloantibodies being undetected; autoantibodies less than 4+, 4667©FUNPEC-RP www.funpecrp.com.br Genetics and Molecular Research 13 (2): 4666-4672 (2014) Red blood cell autoantibodies and alloantibodies will produce the superimposed effect with alloantibodies, resulting in differences in agglutination strength.

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“…It has been demonstrated that when incompatibility is due solely to the presence of the RBC autoantibodies, the survival time of transfused allogeneic RBCs is approximately the same as that of autologous RBCs, therefore RBC transfusion provides only some temporary benefit. 1,19,26 Yürek et al observed no significant hemolytic transfusion reactions due to auto-and/or alloantibodies in 32 AIHA patients during or after RBC transfusion. 27 In this latter study, three patients remained untransfused or had a postponed transfusion and died.…”

Section: Barros Et Almentioning

confidence: 99%

“…This concern relates to the fact that RBC alloantibodies may cause serious acute or delayed hemolytic transfusion reactions in recipients. 1,26 The prevalence of RBC alloantibodies in patients with WAIHA ranges from 7.5% to 54% (Table 3). 17,23,[27][28][29][30][31][32][33] The majority of studies reporting on the high frequency of coexisting alloantibodies and autoantibodies mostly describe patients with serological positive results rather than with clinically confirmed WAIHA.…”

Section: Barros Et Almentioning

confidence: 99%

“…Some studies have demonstrated that RBC transfusion did not result in a significant increase in hemolysis and there are no reports that definitively demonstrate significant exacerbation of hemolysis in patients with true AIHA. 17,[26][27][28] Very rapid transfusion of cold blood components in resuscitation may cause hazardous hypothermia, however blood warming is seldom necessary and associated with considerable risks to the patient. The indication to warm blood units before transfusing patients with CAIHA is controversial, and there are few data indicating its effectiveness.…”

Section: Indications For Transfusion In Aihamentioning

confidence: 99%

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Autoimmune hemolytic anemia: transfusion challenges and solutions

Barros¹,

Langhi²,

Bordin³

2017

IJCTM

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Autoimmune hemolytic anemia (AIHA) is defined as the increased destruction of red blood cells (RBCs) in the presence of anti-RBC autoantibodies and/or complement. Classification of AIHA is based on the optimal auto-RBC antibody reactivity temperatures and includes warm, cold-reactive, mixed AIHA, and drug-induced AIHA subtypes. AIHA is a rare disease, and recommendations for transfusion are based mainly on results from retrospective data and relatively small cohort studies, including heterogeneous patient samples or single case reports. In this article, we will review the challenges and solutions to safely transfuse AIHA patients. We will reflect on the indication for transfusion in AIHA and the difficulty in the accomplishment of immunohematological procedures for the selection of the safest and most compatible RBC units.

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Red blood cell transfusion in warm-type autoimmune haemolytic anaemia

Cited by 82 publications

References 10 publications

Clearance of pathological antibodies using biomimetic nanoparticles

Clearance of pathological antibodies using biomimetic nanoparticles

Effect of superposition and masking between red blood cell autoantibodies and alloantibodies

Autoimmune hemolytic anemia: transfusion challenges and solutions

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