Fetal RHD genotyping after bone marrow transplantation.

Autor: Thurik FF; Department of Experimental Immunohematology, Amsterdam and Landsteiner Laboratory, Academic Medical Center, Sanquin, University of Amsterdam, Amsterdam, The Netherlands.; Division Woman and Baby, Department of Obstetrics, University Medical Center Utrecht, Utrecht, The Netherlands., Page-Christiaens GC; Division Woman and Baby, Department of Obstetrics, University Medical Center Utrecht, Utrecht, The Netherlands., Ait Soussan A; Department of Experimental Immunohematology, Amsterdam and Landsteiner Laboratory, Academic Medical Center, Sanquin, University of Amsterdam, Amsterdam, The Netherlands., Ligthart PC; Department of Immunohematology Diagnostic Services, Sanquin, Amsterdam, The Netherlands., Cheroutre GM; Department of Immunohematology Diagnostic Services, Sanquin, Amsterdam, The Netherlands., Bossers B; Department of Immunohematology Diagnostic Services, Sanquin, Amsterdam, The Netherlands., Veldhuisen B; Department of Experimental Immunohematology, Amsterdam and Landsteiner Laboratory, Academic Medical Center, Sanquin, University of Amsterdam, Amsterdam, The Netherlands.; Department of Immunohematology Diagnostic Services, Sanquin, Amsterdam, The Netherlands., van der Schoot CE; Department of Experimental Immunohematology, Amsterdam and Landsteiner Laboratory, Academic Medical Center, Sanquin, University of Amsterdam, Amsterdam, The Netherlands., de Haas M; Department of Experimental Immunohematology, Amsterdam and Landsteiner Laboratory, Academic Medical Center, Sanquin, University of Amsterdam, Amsterdam, The Netherlands.; Department of Immunohematology Diagnostic Services, Sanquin, Amsterdam, The Netherlands.; Center for Clinical Transfusion Research, Sanquin Research and Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
Jazyk: angličtina
Zdroj: Transfusion [Transfusion] 2016 Aug; Vol. 56 (8), pp. 2122-6. Date of Electronic Publication: 2016 May 30.
DOI: 10.1111/trf.13669
Abstrakt: Background: Fetal RHD genotyping allows targeted diagnostic testing, fetal surveillance, and eventually intrauterine treatment to D-alloimmunized pregnant women who carry an RHD+ fetus. However, false-positive and false-negative results of noninvasive prenatal fetal RHD genotyping have been described due to a variety of causes. In this case report we present two cases where noninvasive fetal RHD typing was complicated by a previous bone marrow transplantation (BMT).
Case Report: We describe two women with a history of allogeneic BMT in early childhood. Both were born D+ and received a transplant of their D- male sibling. Anti-D were detected during pregnancy in one of them. The biologic father of this pregnancy was D+. In both cases polymerase chain reaction procedures specific for RHD on maternal plasma DNA were positive whereas a D- neonate was born in one case (Case 1).
Conclusion: False-positive results of noninvasive fetal RHD genotyping occur in D+ women transplanted with marrow of a D- donor, due to circulating cell-free DNA originating from nonhematopoietic tissue. The cases highlight that health care professionals and laboratories should be aware that allogeneic BMT can be a cause for false-positive results in fetal RHD genotyping with cell-free DNA in maternal plasma, and likewise the wrong fetal sex can be reported in the case of a male donor and a female fetus. Based on one of the cases we also recommend giving D- blood products to young female patients who receive a BMT of D- donors.
(© 2016 AABB.)
Databáze: MEDLINE
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