Marit Jalink, Femke V M Mulder, Marianne E George, Josephine M I Vos, Masja de Haas, Claudia C Folman
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引用次数: 0
Abstract
Background and objectives: Cold agglutinins (CAs) are immunoglobulin M autoantibodies that optimally bind to red blood cells at low temperatures. The clinical significance of CAs is usually characterized by the CA titre and thermal amplitude. However, there is no consensus on the optimal testing strategy. In this study, we sought to unify CA testing.
Materials and methods: A survey on CA evaluation was conducted in 17 Dutch transfusion laboratories. Additionally, samples from 16 patients with CAs were used to evaluate (pre)analytical variations in test outcomes.
Results: The survey on CA evaluation revealed heterogeneity in the indications for CA workup and in (pre)analytical conditions. Titration results between EDTA plasma and serum did not differ. However, titres were higher when 2% bovine serum albumin (BSA) was present in the titration medium. Routinely collected EDTA-blood kept at 37°C for 10 min before plasma isolation (reheated) showed equivalent results to plasma from blood kept at 37°C from collection through separation.
Conclusion: This study showed that different (pre)analytical conditions influence test outcomes in the characterization of CAs. Importantly, CA testing can effectively be performed with reheated blood samples, which will facilitate a more practical workflow for laboratories. International standardization of CA testing for diagnostic use is essential.
期刊介绍：
Vox Sanguinis reports on important, novel developments in transfusion medicine. Original papers, reviews and international fora are published on all aspects of blood transfusion and tissue transplantation, comprising five main sections:
1) Transfusion - Transmitted Disease and its Prevention:
Identification and epidemiology of infectious agents transmissible by blood;
Bacterial contamination of blood components;
Donor recruitment and selection methods;
Pathogen inactivation.
2) Blood Component Collection and Production:
Blood collection methods and devices (including apheresis);
Plasma fractionation techniques and plasma derivatives;
Preparation of labile blood components;
Inventory management;
Hematopoietic progenitor cell collection and storage;
Collection and storage of tissues;
Quality management and good manufacturing practice;
Automation and information technology.
3) Transfusion Medicine and New Therapies:
Transfusion thresholds and audits;
Haemovigilance;
Clinical trials regarding appropriate haemotherapy;
Non-infectious adverse affects of transfusion;
Therapeutic apheresis;
Support of transplant patients;
Gene therapy and immunotherapy.
4) Immunohaematology and Immunogenetics:
Autoimmunity in haematology;
Alloimmunity of blood;
Pre-transfusion testing;
Immunodiagnostics;
Immunobiology;
Complement in immunohaematology;
Blood typing reagents;
Genetic markers of blood cells and serum proteins: polymorphisms and function;
Genetic markers and disease;
Parentage testing and forensic immunohaematology.
5) Cellular Therapy:
Cell-based therapies;
Stem cell sources;
Stem cell processing and storage;
Stem cell products;
Stem cell plasticity;
Regenerative medicine with cells;
Cellular immunotherapy;
Molecular therapy;
Gene therapy.
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