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Immunohematology Immunohematology Journal of Blood Group Serology and Education Celebrating 2 Yea5rs Volume 25, Number 2, 2009 Immunohematology Journal of Blood Group Serology and Education Volume 25, Number 2, 2009 Contents Invited Review: Milestones Series 39 Milestones in laboratory procedures and techniques M.E. Reid Case Report 44 Anti-Kpa–induced severe delayed hemolytic transfusion reaction R. Koshy, B. Patel, and J.S. Harrison Review 48 The ABO blood group system revisited: a review and update J.R. Storry and M.L. Olsson Case Report 60 Clinical evaluation for lymphoproliferative disease prompted by finding of IgM warm autoanti-IT in two cases R.M. Leger, F. Lowder, M.C. Dungo, W. Chen, H.M. Mason, and G. Garratty Original Report 63 Southeast Asian ovalocytosis is associated with increased expression of Duffy antigen receptor for chemokines (DARC) I.J. Woolley, P. Hutchinson, J.C. Reeder, J.W. Kazura, and A. Cortés Review 67 Sickle cell disease: a review S.D. Roseff Report 75 Consortium for Blood Group Genes (CBGG): 2008 report G.A. Denomme, C.M. Westhoff, L. Castilho, and M.E. Reid for the CBGG Special Dedication 81 W. John Judd, FIBMS, MIBiol D. Mallory 82 Letter from the Editors 83 Announcements 84 Advertisements 88 Instructions for Authors Editors-in-Chief Managing Editor Sandra Nance, MS, MT(ASCP)SBB Cynthia Flickinger, MT(ASCP)SBB Philadelphia, Pennsylvania Philadelphia, Pennsylvania Connie M. Westhoff, PhD, MT(ASCP)SBB Technical Editor Philadelphia, Pennsylvania Christine Lomas-Francis, MSc New York City, New York Senior Medical Editor Geralyn M. Meny, MD Philadelphia, Pennsylvania Associate Medical Editors David Moolten, MD Ralph R. Vassallo, MD Philadelphia, Pennsylvania Philadelphia, Pennsylvania Editorial Board Patricia Arndt, MT(ASCP)SBB Brenda J. Grossman, MD Joyce Poole, FIBMS Pomona, California St. Louis, Missouri Bristol, United Kingdom James P. AuBuchon, MD W. John Judd, FIBMS, MIBiol Mark Popovsky, MD Lebanon, New Hampshire Ann Arbor, Michigan Braintree, Massachusetts Martha R. Combs, MT(ASCP)SBB Christine Lomas-Francis, MSc Marion E. Reid, PhD, FIBMS Durham, North Carolina New York City, New York New York City, New York Geoffrey Daniels, PhD Gary Moroff, PhD S. Gerald Sandler, MD Bristol, United Kingdom Rockville, Maryland Washington, District of Columbia Anne F. Eder, MD John J. Moulds, MT(ASCP)SBB Jill R. Storry, PhD Washington, District of Columbia Shreveport, Louisiana Lund, Sweden George Garratty, PhD, FRCPath Paul M. Ness, MD David F. Stroncek, MD Pomona, California Baltimore, Maryland Bethesda, Maryland Emeritus Editorial Board Delores Mallory, MT(ASCP)SBB Supply, North Carolina Editorial Assistant Production Assistant Judith Abrams Marge Manigly Proofreader Copy Editor Lucy Oppenheim Electronic Publisher Mary L. Tod Wilson Tang Immunohematology is published quarterly (March, June, September, and December) by the American Red Cross, National Headquarters, Washington, DC 20006. Immunohematology is indexed and included in Index Medicus and MEDLINE on the MEDLARS system. The contents are also cited in the EBASE/Excerpta Medica and Elsevier BIOBASE/Current Awareness in Biological Sciences (CABS) databases. The subscription price is $40.00 (U.S.) and $50.00 (foreign) per year. Subscriptions, Change of Address, and Extra Copies: Immunohematology, P.O. BOX 40325, Philadelphia, PA 19106 Or call (215) 451-4902 Web site: www.redcross.org/immunohematology Copyright 2009 by The American National Red Cross ISSN 0894-203X Invited Review: Milestones Series Milestones in laboratory procedures and techniques M.E. Reid hen I left England in 1969, hemagglutination was tory used plasma-suspended RBCs, which neutralized most done by sedimentation. In New York, I was intro- antibodies to Lewis and Ch/Rg antigens and thus they did Wduced to centrifugation as a method to speed the not spend time identifying these clinically insignificant an- process. Both approaches accomplished similar goals, but tibodies. Abandonment of unnecessary testing dramatically one was more time efficient. Use of other techniques, such improved the efficiency of testing by manual hemagglutina- as Western immunoblotting, cloning genes, and polymerase tion and did not have a noticeable negative impact on the chain reaction, made it possible to gain much knowledge efficacy of transfusion. Other changes, which occurred with about blood group antigens. the same goal, include using anti-IgG instead of the broad- spectrum reagent in routine antiglobulin tests, eliminating Immunohematology Beginnings the routine direct antiglobulin test (DAT), and not prepar- In 1975, Sandy Ellisor and I from Central California ing eluates from all samples whose RBCs were positive in Region of the American Red Cross (ARC) and Helen Glid- the DAT. den from ARC Headquarters volunteered to co-edit the first Also in the late 1970s, an extraordinary number of American Red Cross Reference Laboratory Newsletter. crossmatches were performed. Indeed, the number was ex- The purpose of this newsletter, which was for the technolo- cessive. The concepts of a “type and screen”2 and a “maxi- gists and by the technologists, was to share techniques and mum surgical blood order schedule”3 were introduced. technical tips, educate, and mentor in technical writing. The These approaches were quickly adopted, and they reduced first year (1976), the newsletter was low-tech; it was simply not only the number of crossmatches but also the number photocopied. That year, the ARC Reference Laboratory of RBC components reserved for a particular patient. Soon Committee ran a competition and by popular vote the news- after, the suggestion to drop the antiglobulin crossmatch letter was renamed the Red Cell Free Press. And to improve for patients who had a negative antibody screen was un- its appearance it was printed. This informal newsletter was leashed.4–6 Despite concerns that antibodies to antigens published for 8 years, until in 1984 it evolved into Immuno- not expressed on screening RBCs (e.g., anti-Wra) would hematology under the able editorship of Delores Mallory.1 be missed, this practice is now commonplace. Indeed, the During the 25-year life of Immunohematology, techniques physical immediate-spin crossmatch is now frequently re- evolved that allowed the gathering of an amazing amount placed by a computer crossmatch.7 of knowledge about blood groups and the membrane com- ponents on which they are carried. Despite this evolution, Use of Enhancement Reagents and Nonserologic to this day we still mainly rely on hemagglutination (direct Techniques and indirect) for detection and identification of antibodies Old standby techniques such as saline and albumin fell to blood group antigens and for testing for incompatibility. from favor and were largely replaced by low-ionic-strength This amazing technique is hard to beat in terms of sensitivi- solution (LISS) methods in the mid-1970s8 and by LISS-ad- ty and specificity that are appropriate for safe transfusions. ditive solutions shortly thereafter. LISS rapidly gained popu- larity because it simultaneously reduced incubation time and Early Immunohematology Testing Practices increased sensitivity. In 1984, the same year that the first vol- In the era before the ARC Newsletter, it was common- ume of Immunohematology appeared, a solid-phase adher- place to perform excessive testing (e.g., testing at room ence assay for detection of antibody-antigen reactions was temperature, use of enzyme-treated RBCs at temperatures introduced. For a review of this technology, see Beck et al.9 below 37ºC, absorbing eluates from autoimmune hemo- Subsequently, other techniques were reported and quickly lytic anemia cases, and performing minor crossmatches) became popular; two examples are the use of polyethylene on a single blood sample. Fortunately, Eloise Giblett in the glycol (PEG) as a potentiator of antibody-antigen reactions early 1960s advocated stopping unnecessary testing; she in 198710 and the column agglutination technology, using believed testing should be done as close to physiologic con- a gel as the support medium, in 1990.11 Automated assays ditions as possible, i.e., testing at 37ºC using plasma-sus- based on hemagglutination and manual or automated solid- pended RBCs. Her reasoning was scholarly and logical and phase adherence assays are now in use, but they have not changed the way testing was (and is) done. Giblett’s labora- replaced hemagglutination tests in tubes in many settings. IMMUNOHEMATOLOGY, Volume 25, Number 2, 2009 39 M.E. Reid Many reagents became commercially available, and as biology techniques have made it possible to convert murine compliance requirements became more stringent, labora- IgG monoclonal antibodies to human IgG or directly agglu- tories reduced the number of reagents they prepared in- tinating IgM.20 house. Safety concerns prompted many changes. Favorite methods fell from grace, such as the use of ether—as a re- Techniques to Predict Clinical Significance of Anti- sult of concerns about its low flash point. Also, teratogenic, bodies carcinogenic, and neurotoxic chemicals became less read- Hemagglutination detects antibodies, but in itself does ily available. Awareness of the potential hazards of work- not predict their clinical significance. Criteria such as titer, ing with certain chemicals and with blood samples that may phase of reactivity, Ig class, IgG subclass, and specificity contain various pathogens led to the strict requirement to (and the historic knowledge of the clinical significance of an wear personal protective
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