PubMed · 1635581
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A P Varki. 1992-08-20. Changing blood types.. https://doi.org/10.1056/nejm199208203270817
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Blood group O and the cysteine allele of the Y/C1584 change in von Willebrand factor (VWF) are enriched in type 1 VWD, but neither causes disease. We investigated the effect of C1584, alone and in combination with the ABO blood group, on the level and properties of plasma VWF. A cohort of 5052 blood donors was recruited: 50 donors were heterozygous for Y/C1584 and 5002 were homozygous for Y/Y1584. Mean VWF antigen (VWF:Ag) for heterozygotes (82 +/- 35 IUdL(-1)) was significantly lower than for homozygotes (111 +/- 37 IUdL(-1)) (P < .001). Foreach ABO blood group, VWF:Ag was decreased among Y/C1584 heterozygotes compared with Y/Y1584 homozygotes; a larger decrease was observed for group O. Among donors with VWF:Ag levels of 50 IUdL(-1) or lower, Y/C1584 heterozygosity was markedly enriched (18%) compared with the entire cohort (1.5%). Blood group O was enriched to a lesser extent (2.4%), but Y/C1584 in conjunction with group O was strikingly enriched (34.8%). VWF collagen binding activity (VWF:CB) and ristocetin cofactor activity (VWF:RCo) were significantly lower for Y/C1584 heterozygotes than for Y/Y1584 homozygotes, and a qualitative difference in Y/C1584 plasma VWF multimer profile was observed compared with that for Y/Y1584 VWF. The data support a multifactorial basis for low VWF levels in some individuals.
BACKGROUND: Although delayed red cell engraftment and/or hemolysis have been thoroughly documented in association with ABO incompatibility between donor and recipient in patients undergoing hematopoietic stem cell transplantation (HSCT), there are no studies defining the general, long term clinical outcome in a large group of pediatric patients. METHODS: We undertook a retrospective single center analysis of children undergoing pediatric allogeneic stem cell transplantation to determine the influence of ABO donor/recipient incompatibility. Outcome was analyzed according to donor type and included survival, graft versus host disease (GvHD), relapse, days of infection, antibiotic use, transfusion requirement and duration of hospital stay. RESULTS: Two hundred and sixteen children (136 males; 80 females, aged 0-19) transplanted between January 1992 and December 2003 were included in the study. Indications for transplantation were hematological malignancies (n=179) and aplastic conditions (n=37). ABO compatibility was documented in 121 donor/recipient pairs. ABO incompatibility was documented in 95 donor/recipient pairs with 40 major, 40 minor and 15 bi-directional incompatible pairs. ABO incompatibility did not influence survival rate (P=0.3762), the incidence of GvHD (P=0.253) or rate of relapse (P=0.930). Recovery of leucocytes was influenced by ABO incompatibility (P=0.0493), but the rate of infection, transfusion requirements and duration of hospital stay are not. CONCLUSION: In the pediatric setting, ABO major and/or minor mismatch between donor and recipient did not significantly influence the outcome of HSCT. The choice of donor should be determined by the degree of HLA match and CMV status in preference to ABO blood group compatibility.
OBJECTIVES: To evaluate whether first-trimester levels of PAPP-A and serum free-beta-human chorionic gonadotrophin (free beta-hCG) vary with maternal blood group and rhesus status and to assess whether this has implications for first-trimester screening for chromosomal anomalies. METHODS: Blood group and rhesus status information was extracted from birth records for women undergoing first-trimester screening. The birth records were combined with prenatal screening records by an in-house developed record linkage software. In 2252 singleton pregnancies of normal obstetric outcome, the median weight-corrected, ethnicity-corrected and smoking-corrected MoM were compared in the various blood groups, using t-tests after log10 transformation of the marker MoM against the whole study group. RESULTS: Only those women with a B rhesus positive blood group had statistically significant higher MoM levels of PAPP-A (0.995 v 0.937). CONCLUSIONS: A larger study is required to establish the validity of this increase in PAPP-A in the B rhesus positive group. If this can be substantiated, the elevation in PAPP-A in this group may require correction when screening for chromosomal anomalies.