151
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Ziza KC, Liao AW, Dezan M, Dinardo CL, Jens E, Francisco RPV, Junior AM, Zugaib M, Levi JE. Determination of Fetal RHD Genotype Including the RHD Pseudogene in Maternal Plasma. J Clin Lab Anal 2016; 31. [PMID: 27595845 DOI: 10.1002/jcla.22052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 07/09/2016] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To examine the accuracy of fetal RHD genotype and RHD pseudogene determination in a multiethnical population. METHODS Prospective study involving D-negative pregnant women. Cell-free DNA was extracted from 1 ml of maternal plasma by an automated system (MagNA Pure Compact, Roche) and real-time PCR was performed in triplicate targeting the RHD gene exons 5 and 7. Inconclusive samples underwent RHD pseudogene testing by real-time PCR analysis employing novel primers and probe. RESULTS A positive result was observed in 128/185 (69.2%) samples and negative in 50 (27.0%). Umbilical cord blood phenotype confirmed all cases with a positive or negative PCR result. Seven (3.8%) cases were found inconclusive (exon 7 amplification only) and RHD pseudogene testing with both conventional and real-time PCR demonstrated a positive result in five of them, while two samples were also RHD pseudogene negative. CONCLUSION Real-time PCR targeting RHD exons 5 and 7 simultaneously in maternal plasma is an accurate method for the diagnosis of fetal D genotype in our population. The RHD pseudogene real-time PCR assay is feasible and is particularly useful in populations with a high prevalence of this allele.
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Affiliation(s)
| | - Adolfo Wenjaw Liao
- Department of Obstetrics and Gynecology, Hospital das Clínicas, São Paulo University Medical School, São Paulo, Brazil
| | - Marcia Dezan
- Fundação Pró-Sangue/Hemocentro de São Paulo, São Paulo, Brazil
| | | | - Eduardo Jens
- Fundação Pró-Sangue/Hemocentro de São Paulo, São Paulo, Brazil
| | | | | | - Marcelo Zugaib
- Department of Obstetrics and Gynecology, Hospital das Clínicas, São Paulo University Medical School, São Paulo, Brazil
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152
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Thurik FF, Page-Christiaens GC, Ait Soussan A, Ligthart PC, Cheroutre GM, Bossers B, Veldhuisen B, van der Schoot CE, de Haas M. FetalRHDgenotyping after bone marrow transplantation. Transfusion 2016; 56:2122-6. [DOI: 10.1111/trf.13669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 04/20/2016] [Accepted: 04/21/2016] [Indexed: 01/15/2023]
Affiliation(s)
- Florentine F. Thurik
- Department of Experimental Immunohematology, Amsterdam and Landsteiner Laboratory, Academic Medical Center; Sanquin, University of Amsterdam; Amsterdam The Netherlands
- Division Woman and Baby, Department of Obstetrics; University Medical Center Utrecht; Utrecht The Netherlands
| | | | - Aicha Ait Soussan
- Department of Experimental Immunohematology, Amsterdam and Landsteiner Laboratory, Academic Medical Center; Sanquin, University of Amsterdam; Amsterdam The Netherlands
| | - Peter C. Ligthart
- Department of Immunohematology Diagnostic Services; Sanquin; Amsterdam The Netherlands
| | | | - Bernadette Bossers
- Department of Immunohematology Diagnostic Services; Sanquin; Amsterdam The Netherlands
| | - Barbera Veldhuisen
- Department of Experimental Immunohematology, Amsterdam and Landsteiner Laboratory, Academic Medical Center; Sanquin, University of Amsterdam; Amsterdam The Netherlands
- Department of Immunohematology Diagnostic Services; Sanquin; Amsterdam The Netherlands
| | - C. Ellen van der Schoot
- Department of Experimental Immunohematology, Amsterdam and Landsteiner Laboratory, Academic Medical Center; Sanquin, University of Amsterdam; Amsterdam The Netherlands
| | - Masja de Haas
- Department of Experimental Immunohematology, Amsterdam and Landsteiner Laboratory, Academic Medical Center; Sanquin, University of Amsterdam; Amsterdam The Netherlands
- Department of Immunohematology Diagnostic Services; Sanquin; Amsterdam The Netherlands
- Center for Clinical Transfusion Research, Sanquin Research and Department of Immunohematology and Blood Transfusion; Leiden University Medical Center; Leiden The Netherlands
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153
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Abstract
Hemolytic disease of the newborn (HDN), an alloimmune disorder due to maternal and fetal blood type incompatibility, is associated with fetal and neonatal complications related to red blood cell (RBC) hemolysis. After delivery, without placental clearance, neonatal hyperbilirubinemia may develop from ongoing maternal antibody-mediated RBC hemolysis. In cases refractory to intensive phototherapy treatment, exchange transfusions (ET) may be performed to prevent central nervous system damage by reducing circulating bilirubin levels and to replace antibody-coated red blood cells with antigen-negative RBCs. The risks and costs of treating HDN are significant, but appear to be decreased by delayed umbilical cord clamping at birth, a strategy that promotes placental transfusion to the newborn. Compared to immediate cord clamping (ICC), safe and beneficial short-term outcomes have been demonstrated in preterm and term neonates receiving delayed cord clamping (DCC), a practice that may potentially be effective in cases RBC alloimmunization.
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Affiliation(s)
- Ryan M McAdams
- Department of Pediatrics, University of Washington, Seattle, WA, USA
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154
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Stegmann TC, Veldhuisen B, Bijman R, Thurik FF, Bossers B, Cheroutre G, Jonkers R, Ligthart P, de Haas M, Haer-Wigman L, van der Schoot CE. Frequency and characterization of known and novel RHD variant alleles in 37 782 Dutch D-negative pregnant women. Br J Haematol 2016; 173:469-79. [PMID: 27018217 DOI: 10.1111/bjh.13960] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 12/14/2015] [Indexed: 11/30/2022]
Abstract
To guide anti-D prophylaxis, Dutch D- pregnant women are offered a quantitative fetal-RHD-genotyping assay to determine the RHD status of their fetus. This allowed us to determine the frequency of different maternal RHD variants in 37 782 serologically D- pregnant women. A variant allele is present in at least 0·96% of Dutch D- pregnant women The D- serology could be confirmed after further serological testing in only 54% of these women, which emphasizes the potential relevance of genotyping of blood donors. 43 different RHD variant alleles were detected, including 15 novel alleles (11 null-, 2 partial D- and 2 DEL-alleles). Of those novel null alleles, one allele contained a single missense mutation (RHD*443C>G) and one allele had a single amino acid deletion (RHD*424_426del). The D- phenotype was confirmed by transduction of human D- erythroblasts, consolidating that, for the first time, a single amino acid change or deletion causes the D- phenotype. Transduction also confirmed the phenotypes for the two new variant DEL-alleles (RHD*721A>C and RHD*884T>C) and the novel partial RHD*492C>A allele. Notably, in three additional cases the DEL phenotype was observed but sequencing of the coding sequence, flanking introns and promoter region revealed an apparently wild-type RHD allele without mutations.
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Affiliation(s)
- Tamara C Stegmann
- Sanquin Research and Landsteiner Laboratory, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Barbera Veldhuisen
- Sanquin Research and Landsteiner Laboratory, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.,Sanquin Diagnostic Services, Amsterdam, The Netherlands
| | - Renate Bijman
- Sanquin Research and Landsteiner Laboratory, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Florentine F Thurik
- Sanquin Research and Landsteiner Laboratory, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | | | | | - Remco Jonkers
- Sanquin Diagnostic Services, Amsterdam, The Netherlands
| | | | - Masja de Haas
- Sanquin Research and Landsteiner Laboratory, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.,Sanquin Diagnostic Services, Amsterdam, The Netherlands
| | - Lonneke Haer-Wigman
- Sanquin Research and Landsteiner Laboratory, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - C Ellen van der Schoot
- Sanquin Research and Landsteiner Laboratory, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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155
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Non-invasive foetal RhD genotyping in admixed populations. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2016; 15:4-5. [PMID: 27136431 DOI: 10.2450/2016.0019-16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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156
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Ngoma AM, Mutombo PB, Ikeda K, Nollet KE, Natukunda B, Ohto H. A systematic review of red blood cell alloimmunization in pregnant women in Africa: time to do better. ACTA ACUST UNITED AC 2016. [DOI: 10.1111/voxs.12270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- A. M. Ngoma
- Department of Epidemiology, Biostatistics and Occupational Health; McGill University; Montreal Quebec Canada
| | - P. B. Mutombo
- School of Public Health; University of Kinshasa; Kinshasa Democratic Republic of Congo
| | - K. Ikeda
- Department of Blood Transfusion and Transplantation Immunology; Fukushima Medical University; Fukushima Japan
- Department of Cardiology and Hematology; Fukushima Medical University; Fukushima Japan
| | - K. E. Nollet
- Department of Blood Transfusion and Transplantation Immunology; Fukushima Medical University; Fukushima Japan
- Radiation Medical Science Center; Fukushima Medical University; Fukushima Japan
| | - B. Natukunda
- Department of Hematology and Transfusion Medicine; Faculty of Medicine; Mbarara University of Science and Technology; Mbarara Uganda
| | - H. Ohto
- Department of Blood Transfusion and Transplantation Immunology; Fukushima Medical University; Fukushima Japan
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157
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Johnsen JM. Using red blood cell genomics in transfusion medicine. HEMATOLOGY. AMERICAN SOCIETY OF HEMATOLOGY. EDUCATION PROGRAM 2015; 2015:168-176. [PMID: 26637717 DOI: 10.1182/asheducation-2015.1.168] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Blood types (blood group antigens) are heritable polymorphic antigenic molecules on the surface of blood cells. These were amongst the first human Mendelian traits identified, and the genetic basis of nearly all of the hundreds of blood types is known. Clinical laboratory methods have proven useful to identify selected blood group gene variants, and use of genetic blood type information is becoming widespread. However, the breadth and complexity of clinically relevant blood group genetic variation poses challenges. With recent advances in next-generation sequencing technologies, a more comprehensive DNA sequence-based genetic blood typing approach is now feasible. This chapter introduces the practitioner to high-resolution genetic blood typing beginning with an overview of the genetics of blood group antigens, the clinical problem of allosensitization, current blood type testing methods, and then discussion of next-generation sequencing and its application to the problem of genetic blood typing.
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Affiliation(s)
- Jill M Johnsen
- Bloodworks Research Institute, and Division of Hematology, University of Washington School of Medicine, Seattle, WA
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