急性髓系白血病血型变化及其与治疗效果的关系  

Blood group changes in acute myeloid leukemia and their relationship with therapeutic effect

作　　者：宋倩倩 杨爽 郝芊萌 张玉林[1] SONG Qianqian;YANG Shuang;HAO Qianmeng;ZHANG Yulin(Department of Blood Transfusion,The Second Affiliated Hospital of Zhenghzou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第二附属医院输血科,河南郑州450000

出　　处：《中国输血杂志》2024年第6期700-704,共5页Chinese Journal of Blood Transfusion

摘　　要：目的探究2名血型正反定型不符且疑似O型的急性髓系白血病患者血型变化,及其与疾病治疗效果的关系。方法血型鉴定使用微柱凝胶法、试管法、吸收放散试验对患者ABO血型做血型血清学分析;微流控芯片法检测ABO的血型基因分型,采用PCR法扩增ABO基因外显子E2~E7,扩增产物用Sanger法进行基因测序。结果2例的常规血型血清学检测结果,均为正定O型,反定A型,正反不符,吸收放散试验结果均有A抗原检出;2例的ABO基因表型均为A型;基因分型结果分别为A_(102)/A_(102);A_(102)/O_(01),基因测序结果显示ABO血型基因SNP位点分别为:467T/T;261G/delG、467C/T。其中1例,随着治疗的有效进展,与抗-A凝集反应强度出现明显地由弱到强的变化。结论在临床中遇到正反定型不符且疑似O型的急性髓系白血病患者标本,我们应重视反定型结果的参考价值,须做吸收放散试验,并结合基因检测结果,做出正确的血型判断,为患者制定合适的输血策略。Objective To explore the blood group changes of two acute myeloid leukemia patients with suspected O type,and their relationship with the therapeutic effect.Methods Serological analysis of ABO blood group of patients was carried out by microcolumn gel method,tube method and absorption-elution test,ABO blood group genotyping was performed by microfluidic chip method.Exons E2 to E7 of ABO gene were amplified by PCR and sequenced by Sanger method.Results The forward typing of two cases were both O type,but the reverse typing were both A type.The absorption-elution test results all showed detection of antigen A.ABO gene phenotype of the two cases were both A,with genotyping results as A_(102)/A_(102)and A_(102)/O_(01),respectively.Sequencing results showed that SNP sites of ABO blood group were 467T/T,261G/delG and 467C/T,respectively.In one case,the intensity of anti-A agglutination reaction changed significantly from weak to strong with the progress of treatment.Conclusion For clinical samples of acute myeloid leukemia patients with ABO forward and reverse typing discrepancy and suspected O type,the result of reverse typing should be valued,and absorption-elution test should be performed to further confirm the ABO blood type combining the genetic test results,so as to develop appropriate blood transfusion strategies for patients.

关 键 词：正反定型不符 急性髓系白血病 治疗效果 ABO血型抗原减弱 基因测序 

分 类 号：R733.71[医药卫生—肿瘤] R457.11[医药卫生—临床医学]