The rare Lu:–6 phenotype in Israel and the clinical significance of anti‐Lu6

Abstract

BACKGROUND: Lu6 is a high‐incidence antigen of the Lutheran blood group. Examples of anti‐Lu6 are rare and are of uncertain clinical significance. CASE REPORT: Three patients were encountered in whom anti‐Lu6 was detected on pretransfusion screening. The patients were all Iranian Jews and were not known to be related. In vitro studies to ascertain the potential clinical significance of the antibody using the monocyte monolayer assay (MMA) were negative in two patients. The third patient received a two‐unit transfusion of incompatible Lu6 RBCs with no signs of hemolysis. However, after the transfusion, the MMA and a chemiluminescence test were positive, whereas a chromium survival study was normal. Thus, the antibody may have changed in its clinical significance. CONCLUSION: Although anti‐Lu6 does not appear to be a clinically significant RBC antibody in all circumstances, transfusion of Lu6 RBCs in patients with anti‐Lu6 should be performed cautiously.

Presença de anticorpo anti-Lutheran B em paciente com leucemia linfóide aguda

“…Há relato na literatura de paciente portadora de neoplasia metastática de mama com a presença de anti-Lu b , em tratamento oncológico, que recebeu duas unidades de CH sem apresentar hemólise imediata ou tardia. 18 Tal fato nos faz pensar que talvez os testes in vitro, para este tipo em particular de anticorpo, tenham maior significado do que in vivo.…”

Review: what to do when all RBCs are incompatible—serologic aspects

“…The six antibodies (three anti-Yt a and one each anti-Lu6, -Cr a , and -At a ) with positive MMAs and normal 1-hour 51 Cr survival results had abnormal 51 Cr results after the 1-hour result. The other antibody (anti-Lu6) with a positive MMA and a normal 51 Cr result was associated with a median survival of 26 days, 53 and thus appears to be falsely positive.…”

Calling for diversity: improving transfusion safety through high-throughput blood group microarray genotyping

“…Differences in abundance for the selected antigens are obvious, although finer ethnicityresolved data is still not available for most antigens. In reality, the distribution of blood group phenotypes can even be very heterogeneous among ethnic groups living in proximity, 10 subgroups within the same ethnicity, 11 or can be restricted to religious groups 12 or even single families. 13 Blood group antigens have far-reaching or even fatal 14 consequences stretching beyond hemolytic transfusion reaction (HTR) and hemolytic disease of the fetus and newborn (HDFN) as they have been shown to be linked to other disease [15][16][17][18] .…”

“…Differences in abundance for the selected antigens are obvious, although finer ethnicity-resolved data is still not available for most antigens. In reality, the distribution of blood group phenotypes can even be very heterogeneous among ethnic groups living in proximity, 10 subgroups within the same ethnicity, 11 or can be restricted to religious groups 12 or even single families. 13…”