溫型自體免疫溶血性貧血病人紅血球血型基因分型平台的建立與血清分型之比究

Establishment of Blood Group Genotyping and Comparisons of Genotyping and Phenotyping in Warm Autoimmune Hemolytic Anemia Patients

溫型自體免疫溶血性貧血病人有泛反應(pan-reactive) 之紅血球溫型自體抗體，會干擾血庫紅血球抗體篩檢及血型血清分型。這類病人常需採用次要血型配合輸血策略，正確分型極為重要，本研究目的探討紅血球基因分型方式是否能提升次要血型鑑定的正確性。我們收集病人及健康無輸血史對照者檢體研究，發現靈敏度高的MALDI-TOF儀器檢測基因型，可克服血清方法在自體抗體干擾或因近期輸血而無法明確測定抗原的問題，正確檢測血球分型，提高選擇正確血品效率。

Patients with warm autoimmune hemolytic anemia (WAIHA) has pan-reactive red cell autoantibodies, which would interfere with routine blood bank testing and red cell minor antigen serologic phenotyping. WAIHA patients who need transfusion are often provided with phenotype-matched red cells to prevent further alloimmunization. However, routine serological phenotyping methods cannot provide reliable phenotyping results in patients with WAIHA because their red cells are coated with autoantibodies.
The aim of this study is to evaluate whether a molecular-based red cell genotyping method would provide reliable typing for WAIHA patients. MALDI-TOF based platform was employed for genotyping. WAIHA patients and healthy controls were recruited and their samples were tested with genotyping and serological phenotyping methods. The results showed that MALDI-TOF based genotyping can correctly determine red cell typing in WAIHA patients and in patients who had recently transfused.