Ann Lab Med 2019; 39(2): 218-222  https://doi.org/10.3343/alm.2019.39.2.218
Red Blood Cell Alloimmunization in Korean Patients With Myelodysplastic Syndrome and Liver Cirrhosis
Hyun-Young Kim, M.D.1, Eun-Jung Cho, M.T.2, Sejong Chun, M.D.3, Kyeong-Hee Kim, M.D.4, and Duck Cho, M.D.2,5
1Department of Laboratory Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea; 2Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; 3Department of Laboratory Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea; 4Department of Laboratory Medicine, Dong-A University College of Medicine, Busan, Korea; 5Stem Cell & Regenerative Medicine Institute, Samsung Medical Center, Seoul, Korea
Corresponding author: Duck Cho, M.D. https://orcid.org/0000-0001-6861-3282
Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-dong, Gangnam-gu, Seoul 06351, Korea
Tel: +82-2-3410-2403
Fax: +82-2-3410-2719
E-mail: duck.cho@skku.edu
Received: May 2, 2018; Revised: July 31, 2018; Accepted: October 11, 2018; Published online: March 1, 2019.
© Korean Society for Laboratory Medicine. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Red blood cell (RBC) alloimmunization varies across human populations and ethnic groups. We evaluated the characteristics of RBC alloimmunization and compared the risk of alloimmunization in Korean patients with myelodysplastic syndrome (MDS) and liver cirrhosis (LC), two representative diseases in which chronic transfusion is required. In total, 115 MDS patients and 202 LC patients transfused with RBCs between 2013 and 2015 were retrospectively included. Twenty patients (6.3%) were newly alloimmunized (five MDS patients, 4.3%; 15 LC patients, 7.4%). The median number of RBC units transfused in alloimmunized patients was nine (interquartile range, 4–15 units). As the number of transfused RBC units increased, the cumulative risk of alloimmunization was higher in LC than in MDS patients (P=0.001). The most common alloantibody detected in patients was anti-E (45%), followed by anti-c (17%), anti-e (10%), anti-C (7%), anti-Fyb (7%), and anti-Jka (7%). The present data indicate the need for matching of extended RBC antigens (Rh, Duffy, and Kidd systems) for chronically transfused patients with MDS and LC in Korea.
Keywords: Red blood cell, Alloimmunization, Myelodysplastic syndrome, Liver cirrhosis, Korea



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