Vox sanguinis · 2026
Evaluating alloimmunization risk in patients with sickle cell disease and in prenatal care patients with RHCE variants.
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Leiva-Torres Gabriel André, Baillargeon Nadia, Constanzo-Yanez Jessica, Robitaille Nancy
Аннотация
BACKGROUND AND OBJECTIVES: Clinically significant alloantibodies complicate transfusion and prenatal care, especially in individuals with genetic variants affecting high-frequency antigens. Many patients from African descent carry RHCE*ceVS alleles, which alter the expression of c (RH4), e (RH5) and hrB (RH31). However, the risk and clinical impact of alloimmunization remain uncertain. We evaluated the alloimmunization in a cohort of patients with a RHCE*ceVS genotype.
MATERIALS AND METHODS: We conducted a retrospective study on 48 patients with a RHCE*ceVS genotype divided into three categories: prenatal care, patients with sickle cell disease (SCD) and other or unspecified diagnosis.
RESULTS: No anti-c, anti-e or anti-hrB were found in prenatal care patients or in patients with other or unspecified diagnosis. Among transfused patients with SCD, 50% developed an anti-e. Anti-hrB was identified in two patients, both with SCD. Warm autoantibodies were found in 58% of transfused patients with SCD, many of whom had an anti-e.
CONCLUSION: The risk of developing anti-e or anti-hrB antibodies was low in patients with an RHCE*ceVS genotype, except in those with SCD. In patients with SCD, the presence of autoantibodies, recent transfusions and technical caveats complicate the assessment of clinical impact; therefore, an individualized evaluation of alloimmunization risk is recommended.
MATERIALS AND METHODS: We conducted a retrospective study on 48 patients with a RHCE*ceVS genotype divided into three categories: prenatal care, patients with sickle cell disease (SCD) and other or unspecified diagnosis.
RESULTS: No anti-c, anti-e or anti-hrB were found in prenatal care patients or in patients with other or unspecified diagnosis. Among transfused patients with SCD, 50% developed an anti-e. Anti-hrB was identified in two patients, both with SCD. Warm autoantibodies were found in 58% of transfused patients with SCD, many of whom had an anti-e.
CONCLUSION: The risk of developing anti-e or anti-hrB antibodies was low in patients with an RHCE*ceVS genotype, except in those with SCD. In patients with SCD, the presence of autoantibodies, recent transfusions and technical caveats complicate the assessment of clinical impact; therefore, an individualized evaluation of alloimmunization risk is recommended.