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Blood, 5 November 2009, Vol. 114, No. 19, pp. 4279-4282.
Prepublished online as a Blood First Edition Paper on August 27, 2009; DOI 10.1182/blood-2009-06-227793.


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TRANSFUSION MEDICINE

Brief report

Immunogenicity of blood group antigens: a mathematical model corrected for antibody evanescence with exclusion of naturally occurring and pregnancy-related antibodies

Christopher A. Tormey1,2, and Gary Stack1,2

1 Pathology and Laboratory Medicine Service, Veterans Affairs (VA) Connecticut Healthcare System, West Haven; and 2 Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT

Blood group antigen immunogenicity is a crucial factor in red blood cell alloimmunization. Previous calculated estimates of immunogenicity suffered from several key shortcomings. To address these issues we have (1) introduced a correction factor for antibody persistence rates into traditional immunogenicity calculations, (2) calculated immunogenicities only in men to eliminate pregnancy-related antibodies, and (3) excluded antibodies reactive only at room temperature to minimize the contribution of naturally occurring antibodies. With these corrections, we have calculated the immunogenicities of common blood group antigens using data collected on clinically significant alloantibodies (n = 452) in a male patient population. We observed a 3- to 5-fold increase in immunogenicity for some antigens (ie, Jka, Cw, Lua) and smaller changes in others compared with traditionally calculated estimates. In addition, we have calculated the transfusion-related immunogenicities of antigens traditionally associated with naturally occurring antibodies (eg, anti-Lea, -Leb, -M, and -P1).


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