-
摘要: 目的：对多发骨髓瘤全凝集病例进行血清学及分子生物学定型，并探讨其输血实践。方法：初检血型呈全凝集者，红细胞37℃生理盐水洗涤3遍，正定型检测仍有凝集时，56℃水浴箱热放散1 min，再次洗涤后做正定型；血浆用多人份O型洗涤红细胞4℃进行吸收4 h，离心取上清做反定型，结果不理想者复做一次；仍未能判读者取上清置37℃水浴30 min再次如上方式进行反定型检测。经上述处理结果仍然不理想时，进一步应用二硫苏糖醇（DTT）处理检测红细胞或患者红细胞。同时采用中和抑制试验测定患者唾液中和血型物质及PCR扩增1~7外显子测序佐证血型。结果：血型全部得以确认；唾液中和试验与基因定型结果与血清学结果一致；配血试验血红蛋白均有提升。结论：全凝集患者血型定型正确，输血效果良好。Abstract: Objective: To do the serology-typing and geno-typing test in multiple myeloma patients with agglutination.Method: For unidentified cases, red blood cells(RBC) was washed with 37℃ saline, and dissipated at 56℃ for 1 min.Serum was absorbed with 4℃ multiple-people-O-type compressed RBC, then RBC and serum were treated with DTT.1 to 7 exons were amplified.The same type of blood or O washed red cells were selected for transfusion.Result: After RBCs washed with saline and serum absorpted with O-type RBC, blood type of the patient 2 was A.After 56℃ dissipating 1 min, blood groups of the patient 3 and 4 were confirmed.Treated with DTT, blood type of the patient 1 was AB.Amplification sequences of 1 to 7 exons were consistent with the serological results.Cross-matching results showed that patient 2 and 4 with primary and secondary blood side were not agglutination, but the patient 1 was.After transfusion, there were no adverse reactions.Conclusion: The blood types of the patients were correct and the transfusion was reasonable.
-
Key words:
- multiple myeloma /
- Dara-interference-blood-typing /
- cold autoantibody
-
-
[1] Kehrer M, Koob S, Strauss A, et al.Multiple Myeloma-Current Status in Diagnostic Testing and Therapy[J].Z Orthop Unfall, 2017, 155:575-586.
[2] Gerecke C, Fuhrmann S, Strifler S, et al.The Diagnosis and Treatment of Multiple Myeloma[J].Dtsch Arztebl Int, 2016, 113:470-476.
[3] Cai X, Jin S, Liu X, et al.Molecular genetic analysis of ABO blood group variations reveals 29 novel ABO subgroup alleles[J].Transfusion, 2013, 53:2910-2916.
[4] Nau KC, Lewis WD.Multiple myeloma:diagnosis and treatment[J].Am Fam Physician, 2008, 78:853-859.
[5] Park J, Jekarl DW, Park SY, et al.Combined Group I and III ABO Discrepancies in Multiple Myeloma with IgG-Lambda Type:A Case Report[J].Med Princ Pract, 2017, 26:90-92.
[6] Kim SY, Oh SH, Park KS, et al.ABO discrepancy in an elderly patient with IgA kappa-type multiple myeloma[J].Ann Hematol, 2010, 89:747-748.
[7] Chapuy CI, Nicholson RT, Aguad MD, et al.Resolving the daratumumab interference with blood compatibility testing[J].Transfusion, 2015, 55:1545-1554.
[8] Roback JD, Grossman BJ, Harris T, et al.Technical manual[M].17th ed.Bethesda(MD):AABB, 2011.
[9] Hosokawa M, Kashiwagi H, Nakayama K, et al.Distinct effects of daratumumab on indirect and direct antiglobulin tests:a new method employing 0.01 mol/L dithiothreitol for negating the daratumumab interference with preserving K antigenicity(Osaka method)[J].Transfusion.2018, 58:3003-3013.
[10] Chapuy CI, Aguad MD, Nicholson RT, et al.International validation of a dithiothreitol(DTT)-based method to resolve the daratumumab interference with blood compatibility testing[J].Transfusion, 2016, 56:2964-2972.
[11] Kleszczyńska H, Bonarska D, Sarapuk J, et al.Protection of erythrocytes against organometals-induced hemolysis[J].J Fluoresc, 2004, 14:5-10.
[12] Chari A, Arinsburg S, Jagannath S, et al.Blood Transfusion Management and Transfusion-Related Outcomes in Daratumumab-Treated Patients With Relapsed or Refractory Multiple Myeloma[J].Clin Lymphoma Myeloma Leuk, 2018, 18:44-51.
[13] Kashyap R, Singh A, Kumar P.Prevalence of autoimmune hemolytic anemia in multiple myeloma:A prospective study[J].Asia Pac J Clin Oncol, 2016, 12:e319-322.
-
计量
- 文章访问数: 136
- PDF下载数: 85
- 施引文献: 0
下载: