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Akiki P, Dedeken L, Ferster A, Doyen V, Dupire G, Nagant C, Smet J, Ghorra N, Ruth I, Lauwers M, Daubie V, Corazza F, El Kenz H. Pilot study on the use of basophil activation tests and skin tests for the prevention of allergic transfusion reactions. FRONTIERS IN ALLERGY 2024; 4:1328227. [PMID: 38260175 PMCID: PMC10801240 DOI: 10.3389/falgy.2023.1328227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 12/22/2023] [Indexed: 01/24/2024] Open
Abstract
Background and objectives Management of severe allergic transfusion reactions (ATR) is challenging. In this study, we investigate the usefulness of skin tests and basophil activation tests (BAT) in chronically transfused patients for the prevention of future ATR. Materials and methods BAT and skin tests were carried with the supernatant of red blood cell (RBC) units for a sickle-cell disease patient under chronic exchange transfusion who has presented a severe ATR, in order to prevent potential future ATR. If the results for both BAT and skin tests were negative, the RBC units could be transfused to the patient. If either one of the results was positive, the tested RBC unit was discarded for the patient. Results 192 RBC units were tested with both tests. The level of results concordance between the two tests was 95%. Out of the 169 negative units with both tests, 118 units were transfused to the patient for which he presented no ATR. Conclusion In our study, combining both BAT and skin tests was associated with a good negative predictive value since we were able to safely transfuse our patient. Further studies are still necessary to confirm this result but this pilot study indicates that skin tests and BAT might help prevent ATR. When BAT is not available, skin tests may also be useful in preventing ATR.
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Affiliation(s)
- Philippe Akiki
- Blood Bank Department, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Laurence Dedeken
- Department of Pediatric Hematology Oncology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium
| | - Alina Ferster
- Department of Pediatric Hematology Oncology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium
| | - Virginie Doyen
- Department of Immuno-Allergology, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Gwendy Dupire
- Department of Immuno-Allergology, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Carole Nagant
- Laboratory of Immunology, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Julie Smet
- Laboratory of Immunology, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Nathalie Ghorra
- Laboratory of Immunology, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Isabelle Ruth
- Blood Bank Department, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Maïlis Lauwers
- Blood Bank Department, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Valery Daubie
- Blood Bank Department, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Francis Corazza
- Laboratory of Immunology, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Hanane El Kenz
- Blood Bank Department, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium
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Usami Y, Yanagisawa R, Kanai R, Ide Y, Konno S, Iwama M, Futatsugi A, Takeshita T, Furui Y, Komori K, Kurata T, Saito S, Tanaka M, Nakazawa Y, Sakashita K, Tozuka M. Basophil activation test for allergic and febrile non-haemolytic transfusion reactions among paediatric patients with haematological or oncological disease. Vox Sang 2023; 118:41-48. [PMID: 36224113 DOI: 10.1111/vox.13365] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/09/2022] [Accepted: 09/18/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND OBJECTIVES Allergic transfusion reactions (ATRs) and febrile non-haemolytic transfusion reactions (FNHTRs) are common, although their mechanisms remain unclear. Immunoglobulin E (IgE)-mediated type I hypersensitivity may be involved in the pathogenesis of ATR. A basophil activation test (BAT) may help elucidate this process. MATERIALS AND METHODS The BAT was based on peripheral blood samples from paediatric patients with a haematological or oncological disease and on samples of residual blood products transfused in each case. Dasatinib was used to evaluate whether basophil activation was mediated by an IgE-dependent pathway. RESULTS Twenty-seven patients with and 19 patients without ATR/FNHTR were included in this study, respectively. The median BAT values associated with ATR- (n = 41) and FNHTR-causing (n = 5) blood products were 22.1% (range = 6.1%-77.0%) and 27.8% (range = 15.2%-47.8%), respectively, which were higher than the median value of 8.5% (range = 1.1%-40.9%) observed in blood products without a transfusion reaction. Dasatinib suppressed basophil activity. BAT values were comparable in patients with ATR regardless of severity. Meanwhile, BAT values analysed with blood products non-causal for ATR/FNHTR were higher in patients with ATR/FNHTR than in those without. CONCLUSION The IgE-mediated type I hypersensitivity may be involved in the pathogenesis of ATR and FNHTR. BAT analyses may help elucidate the underlying mechanisms and identify patients at risk.
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Affiliation(s)
- Yoko Usami
- Department of Laboratory Medicine, Shinshu University Hospital, Matsumoto, Japan.,Life Science Research Centre, Nagano Children's Hospital, Azumino, Japan
| | - Ryu Yanagisawa
- Life Science Research Centre, Nagano Children's Hospital, Azumino, Japan.,Division of Blood Transfusion, Shinshu University Hospital, Matsumoto, Japan.,Centre for Advanced Cell Therapy, Shinshu University Hospital, Matsumoto, Japan
| | - Ryo Kanai
- Division of Blood Transfusion, Shinshu University Hospital, Matsumoto, Japan
| | - Yuichiro Ide
- Department of Laboratory Medicine, Shinshu University Hospital, Matsumoto, Japan.,Life Science Research Centre, Nagano Children's Hospital, Azumino, Japan
| | - Saori Konno
- Department of Laboratory Medicine, Shinshu University Hospital, Matsumoto, Japan.,Life Science Research Centre, Nagano Children's Hospital, Azumino, Japan
| | - Maria Iwama
- Department of Laboratory Medicine, Nagano Children's Hospital, Azumino, Japan
| | - Akiko Futatsugi
- Department of Laboratory Medicine, Nagano Children's Hospital, Azumino, Japan
| | - Tomoko Takeshita
- Department of Laboratory Medicine, Nagano Children's Hospital, Azumino, Japan
| | - Yu Furui
- Department of Haematology and Oncology, Nagano Children's Hospital, Azumino, Japan
| | - Kazutoshi Komori
- Department of Haematology and Oncology, Nagano Children's Hospital, Azumino, Japan
| | - Takashi Kurata
- Department of Haematology and Oncology, Nagano Children's Hospital, Azumino, Japan
| | - Shoji Saito
- Department of Paediatrics, Shinshu University School of Medicine, Matsumoto, Japan
| | - Miyuki Tanaka
- Department of Paediatrics, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yozo Nakazawa
- Department of Paediatrics, Shinshu University School of Medicine, Matsumoto, Japan
| | - Kazuo Sakashita
- Life Science Research Centre, Nagano Children's Hospital, Azumino, Japan.,Department of Haematology and Oncology, Nagano Children's Hospital, Azumino, Japan
| | - Minoru Tozuka
- Life Science Research Centre, Nagano Children's Hospital, Azumino, Japan.,Department of Laboratory Medicine, Nagano Children's Hospital, Azumino, Japan
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Incidence of intraoperative anaphylaxis caused by blood products: a 12-year single-center, retrospective study. J Anesth 2022; 36:390-398. [PMID: 35416534 DOI: 10.1007/s00540-022-03059-2] [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: 12/08/2021] [Accepted: 03/23/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Intraoperative anaphylaxis caused by blood products is uncommon, but it is unclear whether the rarity of this reaction is attributable to the difficulty of diagnosis, underreporting, or both. We investigated the incidence of intraoperative transfusion anaphylaxis and its reporting to the hemovigilance system. METHODS We retrospectively reviewed cases wherein general anesthesia was used at a single hospital during a 12-year period. Cases of intraoperative anaphylaxis were extracted using an electronic search strategy and determined using the recently developed grading and clinical scoring system. The causative blood products were determined by the onset duration based on literature regarding intraoperative transfusion anaphylaxis cases. RESULTS Among the 62,146 general anesthesia cases, 22 cases of intraoperative anaphylaxis were identified, and 11 of the 22 cases received transfusions before the onset of anaphylaxis. Intraoperative transfusion anaphylaxis was defined as occurring within 30 min of transfusion. Finally, nine cases of intraoperative transfusion anaphylaxis were analyzed. The overall incidence of intraoperative transfusion anaphylaxis was 1/3,994, with the highest incidence noted for fresh frozen plasma (1/2146; 95% confidence interval [CI] 1/6610-1/920), platelet concentrate (1/2348; 95% CI 1/92,742-1/422), and red blood cells (1/22,867; 95% CI 1/903,199-1/4,105). No evidence indicated that these cases were reported to the Japanese hemovigilance system, although all intraoperative transfusion anaphylaxis cases were diagnosed by anesthesiologists. CONCLUSION The incidence of intraoperative anaphylaxis caused by blood products was higher than that reported and may be underreported to the Japanese hemovigilance system. Further research, particularly multicenter studies, is needed to confirm our results.
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Yasui K, Enami T, Okamura-Shiki I, Ueda T, Fukushima K, Matsuyama N, Kimura T, Takanashi M, Hosen N, Ikeda T, Takihara Y, Hirayama F. Passive immune basophil activation test for the identification of allergic episodes from various adverse events elicited by haematopoietic cell transplantation: A pilot study. Vox Sang 2021; 117:119-127. [PMID: 34081781 DOI: 10.1111/vox.13131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/19/2021] [Accepted: 04/29/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Haematopoietic cell transplantation (HCT) therapy tends to be associated with various complications including engraftment failure, regimen-related toxicities, and infectious diseases. In addition, HC infusion itself occasionally elicits adverse events (AEs), one of the most common AEs is an allergic reaction. As appropriate laboratory tests have not yet been established to distinguish allergy-mediated AEs from other complications, clinical responses for HCT-related AEs can only be nonspecific. In this pilot study, using passive immune basophil activation test (pi-BAT), we attempted to distinguish an HC infusion-induced allergic reaction from various HCT-related AEs. MATERIALS AND METHODS Using pi-BAT, we examined 34 patients who underwent HCT, that is, 11 with AEs and 23 without AEs as controls. RESULTS Two of the eleven AE cases were pi-BAT positive and, the rest of nine AE cases were negative, while all non-AE cases were negative. Both of the two positive cases showed erythema, tachycardia, plus cough. Because erythema is one of the representative symptom of allergy, those cases could be classified as allergic reaction cases or anaphylaxis cases if tachycardia and cough were concomitant symptoms of erythema. Among the nine AEs with pi-BAT negative result, four cases showed urticaria, four showed vomiting plus diarrhoea, and one showed cough. Urticaria case was strongly suspected of allergy, however, the AE cases were pi-BAT negative. CONCLUSION The pi-BAT may be useful as an auxiliary diagnostic tool to confirm the possible involvement of HC infusion in HCT-related AEs and identify an immunologic mechanism for HCT-related hypersensitivity reactions.
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Affiliation(s)
- Kazuta Yasui
- Research and Development, Japanese Red Cross Kinki Block Blood Center, Ibaraki, Japan
| | - Terukazu Enami
- Division of Hematology and Stem Cell Transplantation, Shizuoka Cancer Center, Nagaizumi-chou, Japan
| | - Ikue Okamura-Shiki
- Division of Hematology and Stem Cell Transplantation, Shizuoka Cancer Center, Nagaizumi-chou, Japan
| | - Tomoaki Ueda
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kentaro Fukushima
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Nobuki Matsuyama
- Research and Development, Japanese Red Cross Kinki Block Blood Center, Ibaraki, Japan
| | - Takafumi Kimura
- Research and Development, Japanese Red Cross Kinki Block Blood Center, Ibaraki, Japan
| | - Minoko Takanashi
- Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - Naoki Hosen
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Takashi Ikeda
- Division of Hematology and Stem Cell Transplantation, Shizuoka Cancer Center, Nagaizumi-chou, Japan
| | - Yoshihiro Takihara
- Research and Development, Japanese Red Cross Kinki Block Blood Center, Ibaraki, Japan
| | - Fumiya Hirayama
- Research and Development, Japanese Red Cross Kinki Block Blood Center, Ibaraki, Japan
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5
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Yanagisawa R. Preventing adverse reactions in pediatric transfusions using washed platelet concentrate. Pediatr Int 2021; 63:391-403. [PMID: 33290634 DOI: 10.1111/ped.14572] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 12/02/2020] [Indexed: 01/04/2023]
Abstract
Blood transfusion is an important form of supportive care in children; however, transfusion-associated adverse reactions (TARs) are a problem. As with adults, allergic transfusion reactions (ATRs) and febrile non-hemolytic transfusion reactions (FNHTRs) are major TARs, and the frequency of ATRs caused by platelet concentrate (PC) tends to be particularly high. The plasma component of the blood product is thought to be a major factor in the onset of TARs such as ATR and FNHTR. By contrast, in children, age, underlying disease, and number of blood transfusions may be relevant patient-related factors. Although acetaminophen or diphenhydramine may be used prophylactically to prevent TARs, there is no clear evidence of their effectiveness. Volume-reduced PC is used to prevent TARs; however, it may be difficult to maintain the quality of platelets. Plasma-replaced PC stored with platelet additive solution raises the concern that TARs cannot be completely prevented by residual plasma. Washed PC removes most of the plasma, so it can effectively prevent ATR and FNHTR. The recent development of platelet additive solution [M-sol, bicarbonate Ringer's solution supplemented with acid-citrate-dextrose formula A (BRS-A)] in Japan has enabled the maintenance of the quality of platelets for long periods. The clinical use of washed PC in Japan has therefore progressed. Washed PC with M-sol or BRS-A for pediatric patients can effectively prevent TARs without diminishing the transfusion effect. The supply of washed PC has begun from the Japanese Red Cross Society, and it has become possible to use washed PC at all medical institutions in Japan.
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Affiliation(s)
- Ryu Yanagisawa
- Division of Blood Transfusion, Shinshu University Hospital, Matsumoto, Japan.,Center for Advanced Cell Therapy, Shinshu University Hospital, Matsumoto, Japan
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6
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Yasui K, Matsuyama N, Takihara Y, Hirayama F. New insights into allergic transfusion reactions and their causal relationships, pathogenesis, and prevention. Transfusion 2020; 60:1590-1601. [DOI: 10.1111/trf.15845] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/22/2020] [Accepted: 04/08/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Kazuta Yasui
- Japanese Red Cross Kinki Block Blood Center Ibaraki Osaka Japan
| | | | | | - Fumiya Hirayama
- Japanese Red Cross Kinki Block Blood Center Ibaraki Osaka Japan
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7
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Yasui K, Takihara Y, Matsuyama N, Kato H, Oka K, Imada K, Ueyama A, Kimura T, Hirayama F. Sensitivity and specificity of passive immune‐basophil activation test to detect allergic transfusion reactions. Transfusion 2019; 59:3308-3313. [DOI: 10.1111/trf.15542] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/23/2019] [Accepted: 08/23/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Kazuta Yasui
- Japanese Red Cross Kinki Block Blood Center Osaka Japan
| | | | | | - Hidefumi Kato
- Department of Transfusion Medicine and Cell Therapy Center Aichi Medical University Nagakute Japan
| | - Kazuhiko Oka
- Department Hematology Japanese Red Cross Osaka Hospital Osaka Japan
| | - Kazunori Imada
- Department Hematology Japanese Red Cross Osaka Hospital Osaka Japan
| | - Atsuko Ueyama
- Department of Pediatrics Rinku General Medical Center Osaka Japan
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8
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Hemmings O, Kwok M, McKendry R, Santos AF. Basophil Activation Test: Old and New Applications in Allergy. Curr Allergy Asthma Rep 2018; 18:77. [PMID: 30430289 PMCID: PMC6244909 DOI: 10.1007/s11882-018-0831-5] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW The basophil activation test (BAT) using flow cytometry has supplanted traditional methods of measuring basophil degranulation using histamine and other mediator release, and can be used for clinical applications as well as to explore the immune mechanisms of effector cell response to allergen. This review discusses the advancements made in clinical, diagnostic and laboratory research of allergy utilizing an ever-evolving BAT. RECENT FINDINGS Being an in vitro surrogate of the allergic reaction that happens in vivo in the sick patient, the BAT can be used to support the diagnosis of various allergic conditions, such as food, drug, respiratory and insect venom allergies, and the assessment of clinical response to allergen-specific immunotherapy and other immunomodulatory treatments. The BAT can also be used for research purposes to explore the mechanisms of allergy and tolerance at the level of the basophil, for instance by manipulating IgE and IgG and their receptors and by studying intracellular signalling cascade in response to allergen. This review covers the applications of the BAT to the clinical management of allergic patients and the increased understanding of the mechanisms of immune response to allergens as well as technological advancements made in recent years.
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Affiliation(s)
- Oliver Hemmings
- Department of Women and Children's Health (Paediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.,Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.,MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - Matthew Kwok
- Department of Women and Children's Health (Paediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.,Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.,MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - Richard McKendry
- Department of Women and Children's Health (Paediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.,Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.,MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - Alexandra F Santos
- Department of Women and Children's Health (Paediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK. .,Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK. .,MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK. .,Children's Allergies Department, Guy's and St. Thomas' NHS Foundation Trust, St. Thomas' Hospital, Westminster Bridge Road, London, UK.
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9
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Yasui K, Matsuyama N, Kimura T, Fujimura Y, Hirayama F. Immunoglobulin (Ig)G antibodies against IgE identified by basophil activation test as the putative causative agent of a serious allergic transfusion reaction: potential utility of the test as a new safety measure for allergic transfusion reactions. Transfusion 2018; 58:2572-2580. [PMID: 30264399 DOI: 10.1111/trf.14878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 06/05/2018] [Accepted: 06/18/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND In most cases of allergic transfusion reactions (ATRs), the causative agents have not been identified and the mechanisms are largely unknown, with a few exceptions. The basophil activation test (BAT) was recently introduced in the field of transfusion to investigate the causal relationships between ATRs and transfusion, as well as the mechanisms behind them. STUDY DESIGN AND METHODS The BAT was used to screen the residual supernatants (SNs) of 43 blood components associated with serious ATRs for those that can activate basophils of many healthy volunteers. The SNs were then fractionated by centrifugal ultrafiltration and protein G column chromatography and each separated fraction was reexamined by the BAT. RESULTS Of the 43 such blood components, one activated basophils from 19 of 21 healthy volunteers. In the blood component, the IgG antibody against IgE was identified as a putative causative agent. CONCLUSION Blood donors who possessed the IgG antibody against IgE may be dangerous to transfusion recipients. The BAT would be useful in identifying such high-risk blood donors, when it is used to screen the blood components associated with serious ATRs for residual SNs that can activate the basophils of many healthy volunteers.
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Affiliation(s)
- Kazuta Yasui
- Japanese Red Cross Kinki Block Blood Center, Ibaraki, Osaka, Japan
| | - Nobuki Matsuyama
- Japanese Red Cross Kinki Block Blood Center, Ibaraki, Osaka, Japan
| | - Takafumi Kimura
- Japanese Red Cross Kinki Block Blood Center, Ibaraki, Osaka, Japan
| | | | - Fumiya Hirayama
- Japanese Red Cross Kinki Block Blood Center, Ibaraki, Osaka, Japan
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10
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Possible Utility of the Basophil Activation Test for the Analysis of Mechanisms Involved in Allergic Transfusion Reactions. Transfus Med Rev 2018; 32:43-51. [DOI: 10.1016/j.tmrv.2017.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/18/2017] [Accepted: 09/07/2017] [Indexed: 12/13/2022]
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11
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Yasui K, Matsuyama N, Okamura-Shiki I, Ikeda T, Ishii K, Furuta RA, Hirayama F. Clinical utility of a passive immune basophil activation test for the analysis of allergic transfusion reactions. Transfusion 2017; 57:2084-2095. [PMID: 28656655 DOI: 10.1111/trf.14208] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 04/24/2017] [Accepted: 04/25/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND In previous studies, we demonstrated that the basophil activation test, which is performed using patient blood and the supernatants from transfused blood components, was able to elucidate not only the causative relationship between allergic transfusion reactions and the transfusion but also the mechanisms behind allergic transfusion reactions. However, for a large number of allergic transfusion reactions, patients are in a state of myelosuppression, and the basophil activation test cannot be performed for these patients because there are insufficient numbers of peripheral blood basophils. STUDY DESIGN AND METHODS To overcome this obstacle, we developed a passive immune basophil activation test, in which patient plasma and residually transfused blood are used as the patient's sources of immunoglobulin E and allergen, respectively, whereas healthy volunteer basophils serve as the responder cell source. The passive immune basophil activation test was performed for two patients who had severe allergic transfusion reactions, using supernatants of the residual platelet concentrates and the patients' own immunoglobulin E. RESULTS There were no differences in either surface immunoglobulin E or activation in response to allergens between untreated basophils and so-called quasi-basophils, in which immunoglobulin E was replaced by a third party's immunoglobulin E. In these patients, the supernatants of the residual platelet concentrates exclusively activated basophils in response to quasi-basophils onto which the patients' immunoglobulin E, but not a third party's immunoglobulin E, was bound. CONCLUSION The passive immune basophil activation test may help clarify the causal relationship between allergic transfusion reactions and transfused blood, even when patients experience myelosuppression.
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Affiliation(s)
- Kazuta Yasui
- Japanese Red Cross Kinki Block Blood Center, Osaka, Japan
| | | | - Ikue Okamura-Shiki
- Division of Hematology and Stem Cell Transplantation, Shizuoka Cancer Center, Shizuoka, Japan
| | - Takashi Ikeda
- Division of Hematology and Stem Cell Transplantation, Shizuoka Cancer Center, Shizuoka, Japan
| | - Kazuyoshi Ishii
- Department of Hematology and Oncology, Kansai Medical University Medical Center, Osaka, Japan
| | - Rika A Furuta
- Japanese Red Cross Kinki Block Blood Center, Osaka, Japan
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