New Technology Capabilities of Direct Antiglobulin Test

AUTOIMMUNE THROMBOCYTOPENIA

EA Poponina, EV Butina, AV Iovdii, OD Maksimov, GA Zaitseva, IV Paramonov

Kirov Research Institute of Hematology and Transfusiology, 72 Krasnoarmeiskaya str., Kirov, Russian Federation, 610027

For citation: Elena Aleksandrovna Poponina, MD, PhD, 72 Krasnoarmeiskaya str., Kirov, Russian Federation, 610027; Tel.: +7(8332)54-51-83; e-mail: senkina.elena@rambler.ru

For correspondence: Poponina EA, Butina EV, Iovdii AV, et al. New Technology Capabilities of Direct Antiglobulin Test. Clinical oncohematology. 2020;13(4):426–9. (In Russ).

DOI: 10.21320/2500-2139-2020-13-4-426-429

ABSTRACT

Background. Direct antiglobulin test (DAT) is used to identify erythrocyte-fixed antibodies and complement components. Gel methods are applied to differentiate immunoglobulin class and subclass in positive DAT, which allows to study the nature of anemia and assess the risk of immune hemolysis.

Aim. To assess the rate of positive DAT in oncohematological patients, to determine class and subclass of erythrocyte-fixed immunoglobulins, and to evaluate their contribution in hemolytic complications.

Materials & Methods. In 393 oncohematological patients at the Kirov Research Institute of Hematology and Transfusiology differentiated DAT was studied using gel test with Bio-Rad (USA) testing sets.

Results. The rate of positive DAT in oncohematological patients varied for different diseases from 6.2 % to 25.2 %, in the total group it was 15.5 %. It accounted for 6.2 % in acute leukemias, 6.3 % in myelodysplastic syndrome, 10 % in chronic myeloid leukemia, 11.9 % in Hodgkin’s lymphoma, 15.4 % in chronic lymphocytic leukemia, 21 % in non- Hodgkin’s lymphoma, and 25.2 % in multiple myeloma. In multiple myeloma, acute leukemia, Hodgkin’s lymphoma, and chronic myeloid leukemia patients the positive test was associated with IgG subclasses 2 and 4. In chronic lymphocytic leukemia and non-Hodgkin’s lymphoma patients IgG1 subclass 1, IgM and C3c, C3d complement components were detected on erythrocyte surfaces. It was shown that IgG2/IgG4 detection was not accompanied by any clinical or laboratory signs of immune hemolysis, IgG1 was responsible for destruction of erythrocytes in 50 % of cases, whereas the detection of C3c, C3d complement components was associated with hemolytic manifestations in 100 % of cases.

Conclusion. Positive DAT should be interpreted in light of laboratory and clinical data. Differentiated test helps to predict hemolytic complications in oncohematological patients.

Keywords: direct antiglobulin test, immunoglobulin class and subclass, immune hemolysis.

Received: April 27, 2020

Accepted: August 20, 2020

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Статистика Plumx английский

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