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Musial LB, Prochaska CL, Moss MF, Cruz BR. Application of blood group genotyping in complex cases of immunohematology. Asian J Transfus Sci 2023; 17:164-168. [PMID: 38274970 PMCID: PMC10807531 DOI: 10.4103/ajts.ajts_171_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 05/29/2022] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Red blood cell (RBC) group systems are depicted by antigens on the surface of RBCs, which when transfused to a recipient that lacks them, can result in alloimmunization. Thus, transfusion of matched RBC components to the recipient is recommended, especially for the more immunogenic blood group antigens, such as Rh (E, e, C, and c), Kell, Kidd, Duffy, and MNS. AIMS The aim of this study was to perform the blood group genotyping from blood samples of 12 polytransfused patients whose phenotyping was inconclusive or incomplete. METHODS The amplicons were amplified by polymerase chain reaction-sequence-specific primers for the following alleles: RHCE (RHCE * C, RHCE * c, RHCE * E, and RHCE * e), KEL (KEL * 01 and KEL * 02), FY (FY * 01 and FY * 02), and KID (JK * 01 and JK * 02), in addition to the GATA1-mutated gene (FY * 02N.01). RESULTS Discrepancies were found in the Rh (E) and Kidd systems, in addition to cases of Fyb antigen silencing attributed to the GATA mutation, which was present in all individuals with Fy (a-b-) phenotype. The technique also solved the inconclusive phenotyping caused by mixed-field agglutination. CONCLUSION The results show the contribution of blood group genotyping in complex immunohematology cases, optimizing the delivery of RBC components suitable for transfusion safety, and expanding the number of compatible donors for patients with the Fy (a-b) phenotype related to the FY (02N.01) allele.
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Affiliation(s)
- Letícia Binhara Musial
- Department of Clinical and Toxicological Analyses, Ponta Grossa State University, Curitiba, Parana, Brazil
| | - Caroline Luise Prochaska
- Division of Production and Immunohematology, Hematology and Hemotherapy Center of Parana, Curitiba, Parana, Brazil
| | - Mariane Faria Moss
- Department of Clinical and Toxicological Analyses, Ponta Grossa State University, Curitiba, Parana, Brazil
| | - Bruno Ribeiro Cruz
- Department of Clinical and Toxicological Analyses, Ponta Grossa State University, Curitiba, Parana, Brazil
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Investigation of Dombrock Blood Group Alleles and Genotypes among Saudi Blood Donors in Southwestern Saudi Arabia. Genes (Basel) 2022; 13:genes13061079. [PMID: 35741842 PMCID: PMC9222856 DOI: 10.3390/genes13061079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 12/07/2022] Open
Abstract
The Dombrock (DO) blood group system has two primary antigens, Doa and Dob, which can cause delayed hemolytic transfusion reactions. The paucity of specific monospecific antibodies can hamper the typing based on these antigens. Thus, blood group genotyping (BGG) was investigated as a possible solution. Sequence-specific primers were designed to target a single nucleotide polymorphism (rs11276) on the ART4 gene encoding the DO*A and DO*B alleles. Blood samples (n = 150) from randomly selected volunteer donors were used. DNA was extracted and resulting PCR products were purified and sequenced. The allelic frequencies of DO*A and DO*B were (n = 122, 40.67%) and (n = 178, 59.33%), respectively. The distributions of DO genotypes were as follows: DO*A/DO*A (n = 20), 13.33%; DO*B/DO*B (n = 48), 32.00%; and DO*A/DO*B (n = 82), 54.67%. In conclusion, this study reports on the allelic frequencies of DO*A and DO*B of the DO blood group system in Jazan Province, Kingdom of Saudi Arabia. Furthermore, this study reports on the prevalence of each genotype, of which DO*A/DO*B was the most abundant. This study contributes significantly to build the current blood donor database in Southwestern Saudi Arabia. Moreover, it may assist in providing safe blood to polytransfused patients and reduce the risk of the red cell alloimmunization.
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Belsito A, Magnussen K, Napoli C. Emerging strategies of blood group genotyping for patients with hemoglobinopathies. Transfus Apher Sci 2016; 56:206-213. [PMID: 28040400 DOI: 10.1016/j.transci.2016.11.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 11/29/2016] [Accepted: 11/30/2016] [Indexed: 02/06/2023]
Abstract
Red cell alloimmunization is a serious problem in chronically transfused patients. A number of high-throughput DNA assays have been developed to extend or replace traditional serologic antigen typing. DNA-based typing methods may be easily automated and multiplexed, and provide reliable information on a patient. Molecular genotyping promises to become cheaper, being not dependent on serologic immunoglobulin reagents. Patients with hemoglobinopathies could benefit from receiving extended genomic typing. This could limit post transfusional complications depending on subtle antigenic differences between donors and patients. Patient/donor compatibility extended beyond the phenotype Rh/Kell may allows improved survival of transfused units of red blood cells (RBC) and lead to reduced need for blood transfusion and leading to less iron overload and reduced risk of alloimmunization. Here we discuss the advantages and limitations of current techniques, that detect only predefined genetic variants. In contrast, target enrichment next-generation sequencing (NGS) has been used to detect both known and de novo genetic polymorphisms, including single-nucleotide polymorphisms, indels (insertions/deletions), and structural variations. NGS approaches can be used to develop an extended blood group genotyping assay system.
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Affiliation(s)
- A Belsito
- Department of Internal Medicine and Specialistic Units Clinical Immunoematology Immunohematology U.O.C. Immunohematology, Transfusion Medicine and Organ Transplant Immunology (SIMT), Regional Reference Laboratory of Transplant Immunology (LIT), Department of Internal Medicine and Specialist Units, Azienda Universitaria Policlinico (AOU), Second University of Naples (SUN), Naples, Italy.
| | - K Magnussen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - C Napoli
- Department of Internal Medicine and Specialistic Units Clinical Immunoematology Immunohematology U.O.C. Immunohematology, Transfusion Medicine and Organ Transplant Immunology (SIMT), Regional Reference Laboratory of Transplant Immunology (LIT), Department of Internal Medicine and Specialist Units, Azienda Universitaria Policlinico (AOU), Second University of Naples (SUN), Naples, Italy
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4
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Meyer S, Vollmert C, Trost N, Sigurdardottir S, Portmann C, Gottschalk J, Ries J, Markovic A, Infanti L, Buser A, Amar el Dusouqui S, Rigal E, Castelli D, Weingand B, Maier A, Mauvais SM, Sarraj A, Braisch MC, Thierbach J, Hustinx H, Frey BM, Gassner C. MNSs genotyping by MALDI-TOF MS shows high concordance with serology, allows gene copy number testing and reveals new St(a) alleles. Br J Haematol 2016; 174:624-36. [DOI: 10.1111/bjh.14095] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 02/15/2016] [Indexed: 12/19/2022]
Affiliation(s)
- Stefan Meyer
- Blood Transfusion Service Zürich; Department of Molecular Diagnostics & Research (MOC); Swiss Red Cross (SRC); Zürich Schlieren Switzerland
| | | | - Nadine Trost
- Blood Transfusion Service Zürich; Department of Molecular Diagnostics & Research (MOC); Swiss Red Cross (SRC); Zürich Schlieren Switzerland
| | - Sonja Sigurdardottir
- Blood Transfusion Service Zürich; Department of Molecular Diagnostics & Research (MOC); Swiss Red Cross (SRC); Zürich Schlieren Switzerland
| | - Claudia Portmann
- Blood Transfusion Service Zürich; Department of Molecular Diagnostics & Research (MOC); Swiss Red Cross (SRC); Zürich Schlieren Switzerland
| | | | - Judith Ries
- Blood Transfusion Service Zürich; SRC; Schlieren Switzerland
| | | | - Laura Infanti
- Blood Transfusion Service beider Basel; SRC; Basel Switzerland
| | - Andreas Buser
- Blood Transfusion Service beider Basel; SRC; Basel Switzerland
| | | | - Emmanuel Rigal
- Blood Transfusion Service Genève; SRC; Geneva Switzerland
| | - Damiano Castelli
- Blood Transfusion Service Svizzera Italiana; SRC; Lugano Switzerland
| | - Bettina Weingand
- Blood Transfusion Service Zentralschweiz; SRC; Lucerne Switzerland
| | - Andreas Maier
- Blood Transfusion Service Zentralschweiz; SRC; Lucerne Switzerland
| | - Simon M. Mauvais
- Blood Transfusion Service Neuchâtel-Jura; SRC; Neuchâtel Switzerland
| | - Amira Sarraj
- Blood Transfusion Service Neuchâtel-Jura; SRC; Neuchâtel Switzerland
| | | | - Jutta Thierbach
- Blood Transfusion Service Ostschweiz; SRC; St. Gallen Switzerland
| | - Hein Hustinx
- Interregional Blood Transfusion; SRC, Ltd.; Bern Switzerland
| | - Beat M. Frey
- Blood Transfusion Service Zürich; SRC; Schlieren Switzerland
| | - Christoph Gassner
- Blood Transfusion Service Zürich; Department of Molecular Diagnostics & Research (MOC); Swiss Red Cross (SRC); Zürich Schlieren Switzerland
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5
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Abstract
The clinical importance of blood group antigens relates to their ability to evoke immune antibodies that are capable of causing hemolysis. The most important antigens for safe transfusion are ABO and D (Rh), and typing for these antigens is routinely performed for patients awaiting transfusion, prenatal patients, and blood donors. Typing for other blood group antigens, typically of the Kell, Duffy, Kidd, and MNS blood groups, is sometimes necessary, for patients who have, or are likely to develop antibodies to these antigens. The most commonly used typing method is serological typing, based on hemagglutination reactions against specific antisera. This method is generally reliable and practical for routine use, but it has certain drawbacks. In recent years, molecular typing has emerged as an alternative or supplemental typing method. It is based on detecting the polymorphisms and mutations that control the expression of blood group antigens, and using this information to predict the probable antigen type. Molecular typing methods are useful when traditional serological typing methods cannot be used, as when a patient has been transfused and the sample is contaminated with red blood cells from the transfused blood component. Moreover, molecular typing methods can precisely identify clinically significant variant antigens that cannot be distinguished by serological typing; this capability has been exploited for the resolution of typing discrepancies and shows promise for the improved transfusion management of patients with sickle cell anemia. Despite its advantages, molecular typing has certain limitations, and it should be used in conjunction with serological methods.
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Evaluation of red blood cell and platelet antigen genotyping platforms (ID CORE XT/ID HPA XT) in routine clinical practice. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2015; 14:160-7. [PMID: 26674823 DOI: 10.2450/2015.0124-15] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 08/31/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND High-throughput genotyping platforms enable simultaneous analysis of multiple polymorphisms for blood group typing. BLOODchip® ID is a genotyping platform based on Luminex® xMAP technology for simultaneous determination of 37 red blood cell (RBC) antigens (ID CORE XT) and 18 human platelet antigens (HPA) (ID HPA XT) using the BIDS XT software. MATERIALS AND METHODS In this international multicentre study, the performance of ID CORE XT and ID HPA XT, using the centres' current genotyping methods as the reference for comparison, and the usability and practicality of these systems, were evaluated under working laboratory conditions. DNA was extracted from whole blood in EDTA with Qiagen methodologies. Ninety-six previously phenotyped/genotyped samples were processed per assay: 87 testing samples plus five positive controls and four negative controls. RESULTS Results were available for 519 samples: 258 with ID CORE XT and 261 with ID HPA XT. There were three "no calls" that were either caused by human error or resolved after repeating the test. Agreement between the tests and reference methods was 99.94% for ID CORE XT (9,540/9,546 antigens determined) and 100% for ID HPA XT (all 4,698 alleles determined). There were six discrepancies in antigen results in five RBC samples, four of which (in VS, N, S and Do(a)) could not be investigated due to lack of sufficient sample to perform additional tests and two of which (in S and C) were resolved in favour of ID CORE XT (100% accuracy). The total hands-on time was 28-41 minutes for a batch of 16 samples. Compared with the reference platforms, ID CORE XT and ID HPA XT were considered simpler to use and had shorter processing times. DISCUSSION ID CORE XT and ID HPA XT genotyping platforms for RBC and platelet systems were accurate and user-friendly in working laboratory settings.
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7
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Fichou Y, Le Maréchal C, Scotet V, Jamet D, Férec C. Insights into RHCE Molecular Analysis in Samples with Partial D Variants: the Experience of Western France. Transfus Med Hemother 2015; 42:372-7. [PMID: 26733768 DOI: 10.1159/000382086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 12/05/2014] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Although systematic blood group genotyping of patients/donors is virtually possible, serological studies remain the gold standard to identify samples of clinical interest that may be further genotyped. In this context, we sought to identify variant D alleles that are likely to be clinically relevant in terms of other Rh antigens in a subset of population genotyped in Western France. METHODS Samples presenting with the RHD*weak D type 4.2.2 allele (n = 47) were selected for the study. RHCE exons 1-7 were directly sequenced, and expression of Rh antigens was predicted on the basis of the molecular data. RESULTS Of the 47 samples tested, 19 (40.4%) were predicted to be of potential clinical interest. Moreover, we could show that selecting the samples to be genotyped by the nature of their variant D allele (i.e., RHD*weak D type 4.2.2 allele) rather than by their Duffy-null status appears to increase significantly the likelihood of identifying clinically relevant individuals for Rh status. CONCLUSION On the basis of our findings we suggest that all individuals genotyped as weak D type 4.2.2 should be systematically screened for RHCE variants by molecular analysis on a routine basis.
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Affiliation(s)
- Yann Fichou
- French Blood Institute (EFS-Bretagne), Brest, France; National Institute of Health and Medical Research (Inserm, UMR1078), Brest, France
| | - Cédric Le Maréchal
- French Blood Institute (EFS-Bretagne), Brest, France; National Institute of Health and Medical Research (Inserm, UMR1078), Brest, France; Faculty of Medicine and Health Sciences, University of Western Brittany, Brest, France; Molecular Genetics and Histocompatibility Laboratory, Regional University Hospital (CHRU), Morvan Hospital, Brest, France
| | - Virginie Scotet
- French Blood Institute (EFS-Bretagne), Brest, France; National Institute of Health and Medical Research (Inserm, UMR1078), Brest, France
| | - Déborah Jamet
- French Blood Institute (EFS-Bretagne), Brest, France
| | - Claude Férec
- French Blood Institute (EFS-Bretagne), Brest, France; National Institute of Health and Medical Research (Inserm, UMR1078), Brest, France; Faculty of Medicine and Health Sciences, University of Western Brittany, Brest, France; Molecular Genetics and Histocompatibility Laboratory, Regional University Hospital (CHRU), Morvan Hospital, Brest, France
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8
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Silvy M, Brès JC, Grimaldi A, Movia C, Muriel V, Roubinet F, Chiaroni J, Bailly P. A simple genotyping procedure without DNA extraction to identify rare blood donors. Vox Sang 2015; 109:173-80. [PMID: 25854538 DOI: 10.1111/vox.12261] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 01/14/2015] [Accepted: 01/19/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Transfusion-induced alloimmunization has severe clinical consequences including haemolytic transfusion reactions, impaired transfused RBCs longevity and greater difficulty in finding compatible blood. Molecular analysis of genomic DNA now permits prediction of blood group phenotypes based on identification of single nucleotide polymorphisms. Implementation of molecular technologies in donor centres would be helpful in finding RBC units for special patient populations, but DNA extraction remains an obstacle to donor genotyping. MATERIALS AND METHODS We propose a simple method compatible with high throughput that allows blood group genotyping using a multiplex commercial kit without the need for DNA extraction. The principle relies on pre-PCR treatment of whole blood using heating/cooling procedure in association with a recombinant hotstart polymerase. RESULTS In a prospective analysis, we yielded 5628 alleles identification and designated 63 donors with rare blood, that is either negative for a high-frequency antigen or with a rare combination of common antigens. CONCLUSION The procedure was optimized for simplicity of use in genotyping platform and would allow not only to supply antigen-matched products to recipients but also to find rare phenotypes. This methodology could also be useful for establishing a donor repository for human platelet antigens (HPA)-matched platelets since the same issues are involved for patients with neonatal alloimmune thrombocytopenia or post-transfusion purpura.
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Affiliation(s)
- M Silvy
- Établissement Français du Sang, Blood Cell Grand Sud, Montpellier-Marseille, France.,UMR 7268 ADÉS Aix-Marseille Université-EFS-CNRS, Marseille, France
| | - J-C Brès
- Établissement Français du Sang, Blood Cell Grand Sud, Montpellier-Marseille, France
| | - A Grimaldi
- UMR 7268 ADÉS Aix-Marseille Université-EFS-CNRS, Marseille, France
| | - C Movia
- UMR 7268 ADÉS Aix-Marseille Université-EFS-CNRS, Marseille, France
| | - V Muriel
- UMR 7268 ADÉS Aix-Marseille Université-EFS-CNRS, Marseille, France
| | - F Roubinet
- Établissement Français du Sang, Blood Cell Grand Sud, Montpellier-Marseille, France
| | - J Chiaroni
- Établissement Français du Sang, Blood Cell Grand Sud, Montpellier-Marseille, France.,UMR 7268 ADÉS Aix-Marseille Université-EFS-CNRS, Marseille, France
| | - P Bailly
- Établissement Français du Sang, Blood Cell Grand Sud, Montpellier-Marseille, France.,UMR 7268 ADÉS Aix-Marseille Université-EFS-CNRS, Marseille, France
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9
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Meyer S, Trost N, Frey BM, Gassner C. Parallel donor genotyping for 46 selected blood group and 4 human platelet antigens using high-throughput MALDI-TOF mass spectrometry. Methods Mol Biol 2015; 1310:51-70. [PMID: 26024625 DOI: 10.1007/978-1-4939-2690-9_5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Most blood group antigens are defined by single nucleotide polymorphisms (SNPs). Highly accurate MALDI-TOF MS has proven its potential in SNP genotyping and was therefore chosen for blood donor oriented genotyping with high-throughput capability, e.g., 380 samples per day. The Select Module covers a total of 36 SNPs in two single-tube reactions, representative of 46 blood group and 4 human platelet antigens. Using this tool, confirmatory blood group typing for RhD, RhCE, Kell, Kidd, Duffy, MN, Ss, and selected rare antigens is performed on a routine basis.
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Affiliation(s)
- Stefan Meyer
- Department of Molecular Diagnostics and Research (MOC), Swiss Red Cross Blood Transfusion Service Zurich, Rütistrasse 19, 8952, Schlieren, Switzerland
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10
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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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11
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Liu Z, Liu M, Mercado T, Illoh O, Davey R. Extended blood group molecular typing and next-generation sequencing. Transfus Med Rev 2014; 28:177-86. [PMID: 25280589 DOI: 10.1016/j.tmrv.2014.08.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 08/11/2014] [Accepted: 08/25/2014] [Indexed: 02/09/2023]
Abstract
Several high-throughput multiplex blood group molecular typing platforms have been developed to predict blood group antigen phenotypes. These molecular systems support extended donor/patient matching by detecting commonly encountered blood group polymorphisms as well as rare alleles that determine the expression of blood group antigens. Extended molecular typing of a large number of blood donors by high-throughput platforms can increase the likelihood of identifying donor red blood cells that match those of recipients. This is especially important in the management of multiply-transfused patients who may have developed several alloantibodies. Nevertheless, current molecular techniques have limitations. For example, they detect only predefined genetic variants. In contrast, target enrichment next-generation sequencing (NGS) is an emerging technology that provides comprehensive sequence information, focusing on specified genomic regions. Target enrichment NGS is able to assess genetic variations that cannot be achieved by traditional Sanger sequencing or other genotyping platforms. Target enrichment NGS has been used to detect both known and de novo genetic polymorphisms, including single-nucleotide polymorphisms, indels (insertions/deletions), and structural variations. This review discusses the methodology, advantages, and limitations of the current blood group genotyping techniques and describes various target enrichment NGS approaches that can be used to develop an extended blood group genotyping assay system.
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Affiliation(s)
- Zhugong Liu
- Division of Blood Components and Devices, Office of Blood Research and Review, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD.
| | - Meihong Liu
- Division of Blood Components and Devices, Office of Blood Research and Review, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD
| | - Teresita Mercado
- Division of Blood Components and Devices, Office of Blood Research and Review, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD
| | - Orieji Illoh
- Division of Blood Components and Devices, Office of Blood Research and Review, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD
| | - Richard Davey
- Division of Blood Components and Devices, Office of Blood Research and Review, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD
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12
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Fichou Y, Audrézet MP, Guéguen P, Le Maréchal C, Férec C. Next-generation sequencing is a credible strategy for blood group genotyping. Br J Haematol 2014; 167:554-62. [PMID: 25135605 DOI: 10.1111/bjh.13084] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 07/04/2014] [Indexed: 01/06/2023]
Abstract
Although several medium/high-throughput tools have been engineered for molecular analysis of blood group genes, they usually rely on the targeting of single nucleotide polymorphisms, while other variants remain unidentified. To circumvent this limitation a strategy for genotyping blood group genes by next-generation sequencing (NGS) was set up. Libraries consisting of exons, flanking introns and untranslated regions of 18 genes involved in 15 blood systems were generated by the Ion AmpliSeq(™) Library Kit 2.0 and by fragmenting polymerase chain reaction products, normalized by two different approaches, mixed and sequenced by the Ion Torrent Personal Genome Machine (PGM(™) ) Sequencer. In our conditions, defined to limit both intra- and inter-sample variability, sequences from mixed libraries were read in a single run for a total coverage of 86·03% of the coding DNA sequences, including all loci defining the most clinically relevant antigens in all genes, except ABO. Importantly, the challenging attempt to generate gene-specific data for the homologous genes was successful. This work, which combines two complementary approaches to generate libraries, defines technical conditions for genotyping blood group genes, illustrates that NGS is suitable for such an application and suggests that, after automation, this novel tool could be used for molecular typing at the laboratory level.
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Affiliation(s)
- Yann Fichou
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1078, Brest, France; Etablissement Français du Sang (EFS) - Bretagne, Brest, France
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Molecular matching for Rh and K reduces red blood cell alloimmunisation in patients with myelodysplastic syndrome. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2014; 13:53-8. [PMID: 24960644 DOI: 10.2450/2014.0332-13] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 02/13/2014] [Indexed: 01/13/2023]
Abstract
BACKGROUND Matching for Rh and K antigens has been used in an attempt to reduce antibody formation in patients receiving chronic transfusions but an extended phenotype matching including Fy(a) and Jk(a) antigens has also been recommended. The aim of this study was to identify an efficient transfusion protocol of genotype matching for patients with myelodysplastic syndrome (MDS) or chronic myelomonocytic leukaemia. We also examined a possible association of HLA class II alleles with red blood cell (RBC) alloimmunisation. MATERIALS AND METHODS We evaluated 43 patients with MDS undergoing transfusion therapy with and without antibody formation. We investigated antigen-matched RBC units for ABO, D, C, c, E, e, K, Fy(a), Fy(b), Jk(a), Jk(b), S, s, Do(a), Do(b) and Di(a) on the patients' samples and on the donor units serologically matched for them based on their ABO, Rh and K phenotypes and presence of antibodies. We also determined the frequencies of HLA-DRB1 alleles in the alloimmunised and non-alloimmunised patients. RESULTS Seventeen of the 43 patients had discrepancies or mismatches for multiple antigens between their genotype-predicted profile and the antigen profile of the units of blood serologically matched for them. We verified that 36.8% of patients had more than one RBC alloantibody and 10.5% of patients had autoantibodies. Although we were able to find a better match for the patients in our extended genotyped/phenotyped units, we verified that matching for Rh and K would be sufficient for most of the patients. We also observed an over-representation of the HLA-DRB1*13 allele in the non-alloimmunised group of patients with MDS. DISCUSSION In our population molecular matching for C, c, E, e, K was able to reduce RBC alloimmunisation in MDS patients. An association of HLA-DRB1*13 and protection from RBC alloimmunisation should be confirmed.
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Haspel RL, Olsen RJ, Berry A, Hill CE, Pfeifer JD, Schrijver I, Kaul KL. Progress and potential: training in genomic pathology. Arch Pathol Lab Med 2014; 138:498-504. [PMID: 24678680 DOI: 10.5858/arpa.2013-0359-sa] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
CONTEXT Genomic medicine is revolutionizing patient care. Physicians in areas as diverse as oncology, obstetrics, and infectious disease have begun using next-generation sequencing assays as standard diagnostic tools. OBJECTIVE To review the role of pathologists in genomic testing as well as current educational programs and future training needs in genomic pathology. DATA SOURCES Published literature as well as personal experience based on committee membership and genomic pathology curricular design. CONCLUSIONS Pathologists, as the directors of the clinical laboratories, must be prepared to integrate genomic testing into their practice. The pathology community has made significant progress in genomics-related education. A continued coordinated and proactive effort will ensure a future vital role for pathologists in the evolving health care system and also the best possible patient care.
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Affiliation(s)
- Richard L Haspel
- From the Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts (Dr Haspel); the Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas (Dr Olsen); the Department of Pathology, University of California San Francisco, San Francisco (Dr Berry); the Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia (Dr Hill); the Department of Pathology, Washington University, St Louis, Missouri (Dr Pfeifer); the Departments of Pathology and Pediatrics and the Center for Genomics and Personalized Medicine, Stanford University Medical Center, Stanford, California (Dr Schrijver); and the Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, Evanston, Illinois (Dr Kaul)
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15
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Meyer S, Vollmert C, Trost N, Brönnimann C, Gottschalk J, Buser A, Frey BM, Gassner C. High-throughput Kell, Kidd, and Duffy matrix-assisted laser desorption/ionization, time-of-flight mass spectrometry-based blood group genotyping of 4000 donors shows close to full concordance with serotyping and detects new alleles. Transfusion 2014; 54:3198-207. [DOI: 10.1111/trf.12715] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 03/05/2014] [Accepted: 04/06/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Stefan Meyer
- Department of Molecular Diagnostics & Cytometry (MOC); Swiss Red Cross; Schlieren Switzerland
| | | | - Nadine Trost
- Department of Molecular Diagnostics & Cytometry (MOC); Swiss Red Cross; Schlieren Switzerland
| | - Chantal Brönnimann
- Department of Molecular Diagnostics & Cytometry (MOC); Swiss Red Cross; Schlieren Switzerland
| | - Jochen Gottschalk
- Blood Transfusion Service Zurich; Swiss Red Cross; Schlieren Switzerland
| | - Andreas Buser
- Blood Transfusion Center Basel; Swiss Red Cross; Basel Switzerland
| | - Beat M. Frey
- Blood Transfusion Service Zurich; Swiss Red Cross; Schlieren Switzerland
| | - Christoph Gassner
- Department of Molecular Diagnostics & Cytometry (MOC); Swiss Red Cross; Schlieren Switzerland
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16
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17
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Genomic analyses of RH alleles to improve transfusion therapy in patients with sickle cell disease. Blood Cells Mol Dis 2013; 52:195-202. [PMID: 24309423 DOI: 10.1016/j.bcmd.2013.11.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 11/01/2013] [Indexed: 12/26/2022]
Abstract
BACKGROUND Red cell (RBC) blood group alloimmunization remains a major problem in transfusion medicine. Patients with sickle cell disease (SCD) are at particularly high risk for developing alloantibodies to RBC antigens compared to other multiply transfused patient populations. Hemagglutination is the classical method used to test for blood group antigens, but depending on the typing methods and reagents used may result in discrepancies that preclude interpretation based on serologic reactivity alone. Molecular methods, including customized DNA microarrays, are increasingly used to complement serologic methods in predicting blood type. The purpose of this study was to determine the diversity and frequency of RH alleles in African Americans and to assess the performance of a DNA microarray for RH allele determination. MATERIAL AND METHODS Two sets of samples were tested: (i) individuals with known variant Rh types and (ii) randomly selected African American donors and patients with SCD. Standard hemagglutination tests were used to establish the Rh phenotype, and cDNA- and gDNA-based analyses (sequencing, PCR-RFLP, and customized RHD and RHCE microarrays were used to predict the genotype). RESULTS In a total of 829 samples (1658 alleles), 72 different alleles (40 RHD and 32 RHCE) were identified, 22 of which are novel. DNA microarrays detected all nucleotides probed, allowing for characterization of over 900 alleles. CONCLUSIONS High-throughput DNA testing platforms provide a means to test a relatively large number of donors and potentially prevent immunization by changing the way antigen-negative blood is provided to patients. Because of the high RH allelic diversity found in the African American population, determination of an accurate Rh phenotype often requires DNA testing, in conjunction with serologic testing. Allele-specific microarrays offer a means to perform high-throughput donor Rh typing and serve as a valuable adjunct to serologic methods to predict Rh type. Because DNA microarrays test for only a fixed panel of allelic polymorphisms and cannot determine haplotype phase, alternative methods such as Next Generation Sequencing hold the greatest potential to accurately characterize blood group phenotypes and ameliorate the clinical course of multiply-transfused patients with sickle cell disease.
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18
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Reid ME. Emily Cooley lecture 2012: Emily Cooley and techniques that have been applied to characterize DO and JR blood groups. Transfusion 2013; 53:1876-83. [PMID: 23581612 DOI: 10.1111/trf.12207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 02/25/2013] [Accepted: 02/25/2013] [Indexed: 11/29/2022]
Abstract
Emily Cooley was a well-respected medical technologist and morphologist with a remarkable skill set. She was highly regarded both professionally and personally. The "Emily Cooley Lectureship and Award" was established to honor her in particular and medical technologists in general. This article first reviews the history of the Emily Cooley award and provides some of the reasons why it carries her name. Then, using two blood group systems, DO and JR, it illustrates how many discoveries regarding blood groups were dependent on access to techniques.
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Affiliation(s)
- Marion E Reid
- Laboratory of Immunochemistry, New York Blood Center, New York, New York
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19
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The Lombardy Rare Donor Programme. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2013; 12 Suppl 1:s249-55. [PMID: 23522888 DOI: 10.2450/2013.0182-12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 11/12/2012] [Indexed: 12/19/2022]
Abstract
BACKGROUND In 2005, the government of Lombardy, an Italian region with an ethnically varied population of approximately 9.8 million inhabitants including 250,000 blood donors, founded the Lombardy Rare Donor Programme, a regional network of 15 blood transfusion departments coordinated by the Immunohaematology Reference Laboratory of the Ca' Granda Ospedale Maggiore Policlinico in Milan. During 2005 to 2012, Lombardy funded LORD-P with 14.1 million euros. MATERIALS AND METHODS During 2005-2012 the Lombardy Rare Donor Programme members developed a registry of blood donors and a bank of red blood cell units with either rare blood group phenotypes or IgA deficiency. To do this, the Immunohaematology Reference Laboratory performed extensive serological and molecular red blood cell typing in 59,738 group O or A, Rh CCDee, ccdee, ccDEE, ccDee, K- or k- donors aged 18-55 with a record of two or more blood donations, including both Caucasians and ethnic minorities. In parallel, the Immunohaematology Reference Laboratory implemented a 24/7 service of consultation, testing and distribution of rare units for anticipated or emergent transfusion needs in patients developing complex red blood cell alloimmunisation and lacking local compatible red blood cell or showing IgA deficiency. RESULTS Red blood cell typing identified 8,747, 538 and 33 donors rare for a combination of common antigens, negative for high-frequency antigens and with a rare Rh phenotype, respectively. In June 2012, the Lombardy Rare Donor Programme frozen inventory included 1,157 red blood cell units. From March 2010 to June 2012 one IgA-deficient donor was detected among 1,941 screened donors and IgA deficiency was confirmed in four previously identified donors. From 2005 to June 2012, the Immunohaematology Reference Laboratory provided 281 complex red blood cell alloimmunisation consultations and distributed 8,008 Lombardy Rare Donor Programme red blood cell units within and outside the region, which were transfused to 2,365 patients with no untoward effects. DISCUSSION Lombardy Rare Donor Programme, which recently joined the ISBT Working Party on Rare Donors, contributed to increase blood transfusion safety and efficacy inside and outside Lombardy.
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Gassner C, Meyer S, Frey BM, Vollmert C. Matrix-Assisted Laser Desorption/Ionisation, Time-of-Flight Mass Spectrometry–Based Blood Group Genotyping—The Alternative Approach. Transfus Med Rev 2013; 27:2-9. [DOI: 10.1016/j.tmrv.2012.10.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Revised: 10/15/2012] [Accepted: 10/15/2012] [Indexed: 01/05/2023]
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