Back to base pairs: What is the genetic risk for red bloodcell alloimmunization?

J J Gerritsma; I Oomen; S Meinderts; C E van der Schoot; B J Biemond; J G van der Bom; K Fijnvandraat; SCORE consortium

doi:10.1016/j.blre.2020.100794

Back to base pairs: What is the genetic risk for red bloodcell alloimmunization?

Blood Rev. 2021 Jul:48:100794. doi: 10.1016/j.blre.2020.100794. Epub 2021 Jan 5.

Authors

J J Gerritsma¹, I Oomen², S Meinderts³, C E van der Schoot⁴, B J Biemond⁵, J G van der Bom⁶, K Fijnvandraat⁷; SCORE consortium

Collaborators

SCORE consortium:
E J van Beers⁸, B J Biemond⁹, M Beijlevelt¹⁰, P P T Brons¹¹, M H Cnossen¹², L Dovern¹³, K Fijnvandraat¹⁴, H Heijboer¹⁰, F Hofstede¹⁵, J L H Kerkhoffs¹⁵, E Nur⁹, C Ootjers¹⁶, P J de Pagter¹⁷, A W Rijneveld¹³, S E M Schols¹⁸, F J Smiers¹⁹, M H Suiker⁸, S A M C Teuben¹², C F J van Tuijn⁹, I van Vliet¹², E Zwagemaker⁸

Affiliations

¹ Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Pediatric Hematology, Amsterdam, the Netherlands; Sanquin Research and Landsteiner Laboratory, Immunopathology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. Electronic address: j.j.gerritsma@amsterdamumc.nl.
² Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Pediatric Hematology, Amsterdam, the Netherlands. Electronic address: i.oomen@amsterdamumc.nl.
³ Sanquin Research and Landsteiner Laboratory, Blood Cell Research, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
⁴ Sanquin Research and Landsteiner Laboratory, Experimental Immunohematology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. Electronic address: e.vanderschoot@sanquin.nl.
⁵ Amsterdam UMC, University of Amsterdam, Department of Hematology, Amsterdam, the Netherlands. Electronic address: b.j.biemond@amsterdamumc.nl.
⁶ Sanquin/LUMC, Center for Clinical Transfusion Research, Leiden, the Netherlands. Electronic address: j.g.vanderbom@lumc.nl.
⁷ Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Pediatric Hematology, Amsterdam, the Netherlands; Leiden University Medical Center, Department of Clinical Epidemiology, Leiden, the Netherlands. Electronic address: c.j.fijnvandraat@amsterdamumc.nl.
⁸ Van Creveldkliniek, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands.
⁹ Department of Hematology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.
¹⁰ Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.
¹¹ Department of Pediatric Hematology, Amalia Children's Hospital, Radboudumc, University Medical Center, Geert Grooteplein Zuid 10, 6500 HB Nijmegen, the Netherlands.
¹² Department of Pediatric Hematology, Erasmus University Medical Center - Sophia Children's Hospital, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands.
¹³ Department of Hematology, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands.
¹⁴ Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands; Sanquin Research, Department of Molecular Cellular Hemostasis, PO Box 9190, 1006 AD Amsterdam, the Netherlands.
¹⁵ Department of Hematology, Haga Hospital, Els Borst-Eilersplein 275, 2545 AA Den Haag, the Netherlands.
¹⁶ Department of Hematology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands.
¹⁷ Department of Pediatric Hematology, Erasmus University Medical Center - Sophia Children's Hospital, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands; Department of Pediatric Hematology, Willem-Alexander Children's Hospital, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands.
¹⁸ Department of Hematology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands.
¹⁹ Department of Pediatric Hematology, Willem-Alexander Children's Hospital, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands.

PMID: 33451870
DOI: 10.1016/j.blre.2020.100794

Abstract

Red blood cell (RBC) alloimmunization is a serious complication of blood transfusions, challenging selection of compatible units for future transfusions. Genetic characteristics may be associated with the risk of RBC alloimmunization and may therefore serve to identify high-risk patients. The aim of this systematic review was to summarize the available evidence on genetic risk factors for RBC alloimmunization. Electronic databases were searched up to April 2020 for studies (Search terms included transfusion, alloimmunization and genetic). A total of 2581 alloimmunized cases and 26,558 controls were derived from 24 studies. The alleles that were most frequently studied and that demonstrated significant associations in a meta-analysis with alloimmunization to the Duffy^a antigen were HLA-DRB1*04 (Odds Ratio 7.80 (95%CI 4.57-13.33)), HLA-DRB1*15 (OR 3.76 (95%CI 2.14-6.59)), and HLA-DRB1*03 (OR 0.12 (95%CI 0.05-0.29)). Furthermore, significant associations with anti-K formation was found for the alleles HLA-DRB1*10 (OR 2.64 (95%CI 1.41-4.95)), HLA*DRB1*11 (OR 2.11, (95%CI 1.34-3.32)), and HLA-DRB1*13 (OR 1.71 (95%CI 1.26-2.33)). Overall, the available evidence was of moderate to low quality, hampering interpretation of reported results. There is an urgent need for high quality evidence on genetic risk factors for RBC alloimmunization.

Keywords: Genetic polymorphisms; RBC alloimmunization; Transfusion.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review

MeSH terms

Alleles
Blood Group Antigens / immunology*
Blood Transfusion
Erythrocytes / immunology*
Genetic Predisposition to Disease*
Humans
Immunization
Isoantibodies / immunology*
Risk Assessment
Risk Factors

Substances

Blood Group Antigens
Isoantibodies