Background: Cold-reactive antibodies such as anti-M, anti-N, anti-P1, anti-Le
a and anti-Le
b, are usually active at cold temperature. Although these antibodies are not considered clinically significant in body temperature, few systematic studies on such cold-reactive antibodies have been reported in Asian populations. Matched (i.e., antigen-negative) red blood cells have been rarely selected and transfused to patients who have a cold-reactive antibody in Japan.
Aim: We conducted a collaborative study to clarify whether cold-reactive antibodies such as anti-M, anti-N, anti-P1, anti-Le
a and anti-Le
b can cause hemolytic transfusion reactions in patients.
Methods: From April 2007 to March 2011, screening of cold-reactive antibody in recipients who were transfused with randomly selected red blood cells was routinely tested. Antigens of transfused red blood cells were retrospectively determined. Recipients transfused with antigen-positive red blood cells against cold-reactive antibody were followed-up by measuring markers of hemolysis, particularly serum lactate dehydrogenase (LDH), alanine transaminase (ALT), and total bilirubin, to determine whether hemolytic reaction had occurred after transfusion.
Results: 55 patients with positive cold-reactive antibodies received 79 blood transfusions with antigen-positive red blood cells. Among 18 anti-M, 13 anti-P1, 16 anti-Le
a, 31 anti-Le
b and 1 anti-Le
a+b recipients, no patient developed clinically significant hemolysis.
Conclusion: These results support the idea that patients having cold-reactive antibodies can be transfused with antigen-positive red cells without any side effects. However, studies with more cases are needed to draw a concrete conclusion.
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