Change of ABO blood group in a patient with Acute Myelocytic Leukemia (AML): a case report

Ni Ketut Puspa Sari; Ni Kadek Mulyantari; Sianny Herawati; Anak Agung Wiradewi Lestari; Ni Nyoman Mahartini; I Nyoman Wande

doi:10.15562/ijbs.v17i1.428

Change of ABO blood group in a patient with Acute Myelocytic Leukemia (AML): a case report

Ni Ketut Puspa Sari ,

Ni Kadek Mulyantari ,

Sianny Herawati ,

Anak Agung Wiradewi Lestari ,

Ni Nyoman Mahartini ,

I Nyoman Wande ,

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DOI: https://doi.org/10.15562/ijbs.v17i1.428 |
Published: 2023-04-14

Abstract

Background: ABO and Rhesus blood groups are clinically important, especially in blood transfusion. Blood groups are determined by the antigens found on the erythrocyte membrane. In patients with hematologic malignancies, especially from the myeloid lineage, changes in blood group can occur in the ABO system mainly due to weakness or loss of some ABO antigens.

Case Description: A nine-year-old girl was admitted to the hospital with a chief complaint of high fever three days before admission. The patient had been diagnosed with acute non-lymphoblastic leukemia three months ago. From medical history, the patient had undergone chemotherapy and received 22 bags of PRC transfusion with blood group O (+) from February 27^th until May 28^th 2018. On July 21^st 2018, the transfusion procedure was repeated, and the blood group showed B (+). The procedure was repeated using a new sample but the result remained the same. The crossmatch was performed with five blood groups O (+) and two blood groups B (+) showed mayor: negative, minor:+weak, AC:+weak, mayor: negative, minor:+weak, AC:+weak, respectively.

Conclusion: Changes in blood group antigens in hematologic malignancies that experience ABO antigen alternation and return to the original blood group reflect the remission from the disease. The expression of H antigen in blood groups A and B may revert to normal with an improvement from the underlying disease.

References

Bianco T, Farmer BJ, Sage RE, Dobrovic A. Loss of red cell A, B, and H antigens is frequent in myeloid malignancies. Blood. 2001;97(11):3633-3639.
Dover GJ, Boyer SH, Zinkham WH, Kazazian HH Jr, Pinney DJ, Sigler A. Changing erythrocyte populations in juvenile chronic myelocytic leukemia: evidence for disordered regulation. Blood. 1977;49(3):355-365.
Yoshida A, Kumazaki T, Davé V, Blank J, Dzik WH. Suppressed expression of blood group B antigen and blood group galactosyltransferase in a preleukemic subject. Blood. 1985;66(4):990-992.
Bartova A, Novotny Z, Slepicka J. Changes in the group A antigen in a case of acute myeloblastic leukemia. Blood. 1962;19:566-572.
Kuhns WJ, Oliver RT, Watkins WM, Greenwell P. Leukemia-induced alterations of serum glycosyltransferase enzymes. Cancer Res. 1980;40(2):268-275.
Kolins J, Holland PV, McGinniss MH. Multiple red cell antigen loss in acute granulocytic leukemia. Cancer. 1978;42(5):2248-2253.
Bianco-Miotto T, Hussey DJ, Day TK, O'Keefe DS, Dobrovic A. DNA methylation of the ABO promoter underlies loss of ABO allelic expression in a significant proportion of leukemic patients. PLoS One. 2009;4(3):e4788.
Allard S. Blood Transfusion. Medicine (Baltimore). 2013;41(4):242-247
Nambiar RK, Narayanan G, Prakash NP, Vijayalakshmi K. Blood group change in acute myeloid leukemia. Proc (Bayl Univ Med Cent). 2017;30(1):74-75.
Winters JL, Howard DS. Red blood cell antigen changes in malignancy: case report and review. Immunohematology. 2001;17(1):1-9.
van der HART, van der VEER, van LOGHEM J. Change of blood group B in a case of leukaemia. Vox Sang. 1962;7:449-453.
Gold ER, Tovey GH, Benny WE, Lewis FJW. Changes in group A antigen in a case of leukaemia. Nature. 1959;183(4665):892–893.
Sharma S, Sharma DC, Rai S, Arya A, Jain R, Kaur D, et al. Prevalence of ABO, RhD and other clinically significant Blood Group Antigens among blood donors at tertiary care center, Gwalior. Bali Medical Journal. 2020;9(2):437-443.

[1] Bianco T, Farmer BJ, Sage RE, Dobrovic A. Loss of red cell A, B, and H antigens is frequent in myeloid malignancies. Blood. 2001;97(11):3633-3639.

[2] Dover GJ, Boyer SH, Zinkham WH, Kazazian HH Jr, Pinney DJ, Sigler A. Changing erythrocyte populations in juvenile chronic myelocytic leukemia: evidence for disordered regulation. Blood. 1977;49(3):355-365.

[3] Yoshida A, Kumazaki T, Davé V, Blank J, Dzik WH. Suppressed expression of blood group B antigen and blood group galactosyltransferase in a preleukemic subject. Blood. 1985;66(4):990-992.

[4] Bartova A, Novotny Z, Slepicka J. Changes in the group A antigen in a case of acute myeloblastic leukemia. Blood. 1962;19:566-572.

[5] Kuhns WJ, Oliver RT, Watkins WM, Greenwell P. Leukemia-induced alterations of serum glycosyltransferase enzymes. Cancer Res. 1980;40(2):268-275.

[6] Kolins J, Holland PV, McGinniss MH. Multiple red cell antigen loss in acute granulocytic leukemia. Cancer. 1978;42(5):2248-2253.

[7] Bianco-Miotto T, Hussey DJ, Day TK, O'Keefe DS, Dobrovic A. DNA methylation of the ABO promoter underlies loss of ABO allelic expression in a significant proportion of leukemic patients. PLoS One. 2009;4(3):e4788.

[8] Allard S. Blood Transfusion. Medicine (Baltimore). 2013;41(4):242-247

[9] Nambiar RK, Narayanan G, Prakash NP, Vijayalakshmi K. Blood group change in acute myeloid leukemia. Proc (Bayl Univ Med Cent). 2017;30(1):74-75.

[10] Winters JL, Howard DS. Red blood cell antigen changes in malignancy: case report and review. Immunohematology. 2001;17(1):1-9.

[11] van der HART, van der VEER, van LOGHEM J. Change of blood group B in a case of leukaemia. Vox Sang. 1962;7:449-453.

[12] Gold ER, Tovey GH, Benny WE, Lewis FJW. Changes in group A antigen in a case of leukaemia. Nature. 1959;183(4665):892–893.

[13] Sharma S, Sharma DC, Rai S, Arya A, Jain R, Kaur D, et al. Prevalence of ABO, RhD and other clinically significant Blood Group Antigens among blood donors at tertiary care center, Gwalior. Bali Medical Journal. 2020;9(2):437-443.

Change of ABO blood group in a patient with Acute Myelocytic Leukemia (AML): a case report

Abstract

References

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