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Cripps K, Mullanfiroze K, Hill A, Moss R, Kricke S. Prevalence of adsorbed A antigen onto donor-derived group O red cells in children following stem cell transplantation: A single-centre evaluation. Vox Sang 2023; 118:153-159. [PMID: 36484329 DOI: 10.1111/vox.13386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVES A group AB D-positive child presented 1 year after haematopoietic stem cell transplant (HSCT) from a group O D-negative donor as group A D-negative. Engraftment remained at 100% in white cell lineages. The reason for the unusual result was explored, and the scarcely reported phenomenon of adsorption of secreted antigen was considered. This study also investigated the prevalence of secreted antigen adsorbed onto donor-derived group O red blood cells (RBCs) in children after HSCT and defined a process for laboratory management. MATERIALS AND METHODS Retrospective data analysis of HSCTs carried out over 19 months at Great Ormond Street Hospital was conducted to identify cases of adsorbed A antigen after HSCT. Investigation of RBC reactions with different clones of anti-A and in vitro experiments was performed to recreate adsorption. RESULTS Nineteen A to O HSCTs were conducted over 19 months, of which six (31%) displayed weak A antigen on RBCs despite full myeloid engraftment. Negative reactions with anti-A were obtained when run on an alternative clone. Laboratory protocols for the future management of these cases have been developed. CONCLUSION Passive adsorption of secreted antigen is responsible for these results and is more widespread than previously reported, as a third of A to O HSCTs at our centre demonstrated this phenomenon. A process has been implemented into the laboratory to manage this cohort, ensuring component groups compatible with both donor and recipient are given, and the shared care centres are aware of these requirements.
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Affiliation(s)
- Kelly Cripps
- Blood Transfusion, Department of Haematology, Paediatric Laboratory Medicine, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Khushnuma Mullanfiroze
- Department of Blood and Marrow Transplant, Level 1, Zayed Centre for Research, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Annette Hill
- Department of Blood and Marrow Transplant, Level 1, Zayed Centre for Research, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Rachel Moss
- Blood Transfusion, Department of Haematology, Paediatric Laboratory Medicine, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Susanne Kricke
- Molecular Haematology, Paediatric Laboratory Medicine, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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Steyer A, Konte T, Sagadin M, Kolenc M, Škoberne A, Germ J, Dovč-Drnovšek T, Arnol M, Poljšak-Prijatelj M. Intrahost Norovirus Evolution in Chronic Infection Over 5 Years of Shedding in a Kidney Transplant Recipient. Front Microbiol 2018; 9:371. [PMID: 29552005 PMCID: PMC5840165 DOI: 10.3389/fmicb.2018.00371] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 02/16/2018] [Indexed: 11/13/2022] Open
Abstract
Noroviruses are the leading cause of acute gastroenteritis, and they can affect humans of all age groups. In immunocompromised patients, norovirus infections can develop into chronic diarrhea or show prolonged asymptomatic virus shedding. Chronic norovirus infections are frequently reported for solid organ transplant recipients, with rapid intrahost norovirus evolution seen. In this report, we describe a case of chronic norovirus infection in an immunocompromised patient who was followed up for over 5 years. The purpose of the study was to specify the norovirus evolution in a chronically infected immunocompromised host and identify possible selection sites in norovirus capsid protein. During the follow-up period, 25 sequential stool samples were collected and nine of them were selected to generate amplicons covering viral RNA-dependent RNA polymerase (RdRp) and viral capsid protein (VP1) genes. Amplicons were sequenced using next-generation sequencing. Single nucleotide polymorphisms were defined, which demonstrated a nearly 3-fold greater mutation rate in the VP1 genome region compared to the RdRp genome region (7.9 vs. 2.8 variable sites/100 nucleotides, respectively). This indicates that mutations in the virus genome were not accumulated randomly, but are rather the result of mutant selection during the infection cycle. Using ShoRAH software we were able to reconstruct haplotypes occurring in each of the nine selected samples. The deduced amino-acid haplotype sequences were aligned and the positions were analyzed for selective pressure using the Datamonkey program. Only 12 out of 25 positive selection sites were within the commonly described epitopes A, B, C, and D of the VP1 protein. New positive selection sites were determined that have not been described before and might reflect adaptation of the norovirus toward optimal histo-blood-group antigen binding, or modification of the norovirus antigenic properties. These data provide new insights into norovirus evolutionary dynamics and indicate new putative epitope “hot-spots” of modified and optimized norovirus–host interactions.
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Affiliation(s)
- Andrej Steyer
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, Ljubljana, Slovenia
| | - Tilen Konte
- Faculty of Medicine, Institute of Biochemistry, University of Ljubljana, Ljubljana, Slovenia
| | - Martin Sagadin
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, Ljubljana, Slovenia
| | - Marko Kolenc
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, Ljubljana, Slovenia
| | - Andrej Škoberne
- Department of Nephrology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Julija Germ
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, Ljubljana, Slovenia
| | | | - Miha Arnol
- Department of Nephrology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Mateja Poljšak-Prijatelj
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, Ljubljana, Slovenia
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Canaani J, Savani BN, Labopin M, Huang XJ, Ciceri F, Arcese W, Tischer J, Koc Y, Bruno B, Gülbas Z, Blaise D, Maertens J, Ehninger G, Mohty M, Nagler A. Impact of ABO incompatibility on patients' outcome after haploidentical hematopoietic stem cell transplantation for acute myeloid leukemia - a report from the Acute Leukemia Working Party of the EBMT. Haematologica 2017; 102:1066-1074. [PMID: 28255020 PMCID: PMC5451338 DOI: 10.3324/haematol.2016.160804] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 02/20/2017] [Indexed: 01/07/2023] Open
Abstract
A significant proportion of hematopoietic stem cell transplants are performed with ABO-mismatched donors. The impact of ABO mismatch on outcome following transplantation remains controversial and there are no published data regarding the impact of ABO mismatch in acute myeloid leukemia patients receiving haploidentical transplants. Using the European Blood and Marrow Transplant Acute Leukemia Working Group registry we identified 837 patients who underwent haploidentical transplantation. Comparative analysis was performed between patients who received ABO-matched versus ABO-mismatched haploidentical transplants for common clinical outcome variables. Our cohort consisted of 522 ABO-matched patients and 315 ABO-mismatched patients including 150 with minor, 127 with major, and 38 with bi-directional ABO mismatching. There were no significant differences between ABO matched and mismatched patients in terms of baseline disease and clinical characteristics. Major ABO mismatching was associated with inferior day 100 engraftment rate whereas multivariate analysis showed that bi-directional mismatching was associated with increased risk of grade II–IV acute graft-versus-host disease [hazard ratio (HR) 2.387; 95% confidence interval (CI): 1.22–4.66; P=0.01). Non-relapse mortality, relapse incidence, leukemia-free survival, overall survival, and chronic graft-versus-host disease rates were comparable between ABO-matched and -mismatched patients. Focused analysis on stem cell source showed that patients with minor mismatching transplanted with bone marrow grafts experienced increased grade II–IV acute graft-versus-host disease rates (HR 2.03; 95% CI: 1.00–4.10; P=0.04). Patients with major ABO mismatching and bone marrow grafts had decreased survival (HR=1.82; CI 95%: 1.048 – 3.18; P=0.033). In conclusion, ABO incompatibility has a marginal but significant clinical effect in acute myeloid leukemia patients undergoing haploidentical transplantation.
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Affiliation(s)
- Jonathan Canaani
- Hematology Division, Chaim Sheba Medical Center, Tel-Hashomer, Tel Aviv University, Israel
| | - Bipin N Savani
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Myriam Labopin
- Acute Leukemia Working Party-EBMT and Department of Hematology and Cell Therapy, Hȏpital Saint-Antoine, Paris, France.,INSERM UMR 938, Paris, France.,Université Pierre et Marie Curie, Paris, France
| | - Xiao-Jun Huang
- Peking University People's Hospital, Institute of Haematology, Xicheng District, Beijing, China
| | - Fabio Ciceri
- Ospedale San Raffaele s.r.l., Haematology and BMT, Milano, Italy
| | - William Arcese
- Tor Vergata University of Rome, Stem Cell Transplant Unit, Policlinico Universitario Tor Vergata, Italy
| | | | - Yener Koc
- Medical Park Hospitals, Stem Cell Transplant Unit, Antalya, Turkey
| | - Benedetto Bruno
- S.S.C.V.D Trapianto di Cellule Staminali A.O.U Citta della Salute e della Scienza di Torino, Italy
| | - Zafer Gülbas
- Anadolu Medical Center Hospital, Bone Marrow Transplantation Department, Kocaeli, Turkey
| | - Didier Blaise
- Programme de Transplantation & Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, France
| | - Johan Maertens
- University Hospital Gasthuisberg, Department of Hematology, Leuven, Belgium
| | - Gerhard Ehninger
- Universitaetsklinikum Dresden Medizinische Klinik und Poliklinik I, Germany
| | - Mohamad Mohty
- Acute Leukemia Working Party-EBMT and Department of Hematology and Cell Therapy, Hȏpital Saint-Antoine, Paris, France.,INSERM UMR 938, Paris, France.,Université Pierre et Marie Curie, Paris, France
| | - Arnon Nagler
- Hematology Division, Chaim Sheba Medical Center, Tel-Hashomer, Tel Aviv University, Israel .,Acute Leukemia Working Party-EBMT and Department of Hematology and Cell Therapy, Hȏpital Saint-Antoine, Paris, France.,Université Pierre et Marie Curie, Paris, France
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Drexler B, Holbro A, Sigle J, Gassner C, Frey BM, Schaub S, Amico P, Plattner A, Infanti L, Menter T, Mihatsch MJ, Stern M, Buser A, Dickenmann M. Impact of donor ABH-secretor status in ABO-mismatched living donor kidney transplantation. Transfusion 2016; 56:2355-61. [PMID: 27397630 DOI: 10.1111/trf.13711] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 03/22/2016] [Accepted: 04/25/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND The ABO blood group is a major determinant in living donor kidney transplantation since AB antigens are expressed on renal tissue. Little attention has been directed to the ABH-secretor status of the donor kidney. As renal tissue is capable of secreting soluble ABH antigens in secretors, we examined the influence of the ABH-secretor status of kidney donors on outcome in ABO-mismatched living donor kidney transplantation. STUDY DESIGN AND METHODS We retrospectively analyzed all patients who underwent ABO-mismatched kidney transplantation at the University Hospital Basel from September 2005 to October 2013. The ABH-secretor status was determined in all donors by molecular genetic analysis. RESULTS Of all 55 patients who received transplants, we excluded all patients with donor-specific antibodies (n = 4). Forty-one donors were secretors (78%) and 11 were nonsecretors (22%). Recipients of ABH-secretor donor organs showed a significantly higher glomerular filtration rate throughout the first 6 months posttransplant, whereas no significant influence on posttransplant anti-A/B titers was found. Regression analysis revealed a significant impact on humoral rejection, whereas not on vascular or interstitial rejection in protocol kidney biopsies. CONCLUSION The donor ABH-secretor status may have an influence on early posttransplant renal function in patients undergoing ABO-mismatched living donor kidney transplantation. Further prospective studies with long-term follow-up are needed to elucidate involved pathomechanisms.
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Affiliation(s)
- Beatrice Drexler
- Department of Haematology, University Hospital Basel, Basel. .,Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland.
| | - Andreas Holbro
- Department of Haematology, University Hospital Basel, Basel.,Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland
| | - Joerg Sigle
- Blood Transfusion Centre, Swiss Red Cross, Aarau, Switzerland
| | | | - Beat M Frey
- Blood Transfusion Service, Swiss Red Cross, Zurich, Switzerland
| | | | | | - Alexandra Plattner
- Department of Haematology, University Hospital Basel, Basel.,Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland
| | - Laura Infanti
- Department of Haematology, University Hospital Basel, Basel.,Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland
| | - Thomas Menter
- Institute for Pathology, University Hospital Basel, Basel, Switzerland
| | | | - Martin Stern
- Immunotherapy Laboratory, Department of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - Andreas Buser
- Department of Haematology, University Hospital Basel, Basel.,Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland
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