Objective To confirm the type of autoantibodies in one patient with autoimmune hemolytic anemia (AIHA) by Coombs test using microcolumn gel technique, and to learn from such situations in order to reduce the adverse reaction of blood transfusion. Methods The DAT was performed with the Coombs reagent using microcolumn gel card; cross-matching was conducted both through microcolumn gel technique and polybrene test. Results A positive result of the DAT test indicated the specific antibody typing of IgA.The results of cross-matching using microcolumn gel card were negative, while the results detected by polybrene test were positive. Conclusion For AIHA patients with an isolated IgA antibody, additional polybrene tests should be performed during cross-matching besides microcolumn gel technique, in order to make the correct diagnosis.

>自身免疫性溶血性贫血（AIHA）是一种由B淋巴细胞功能亢进,产生抗自身红细胞抗体,发生溶血或贫血的获得性疾病,年发病率为（1～3）/10～6 [1] 。温抗体型AIHA（wAIHA）占50%～70% [2] ,主要为IgG型或C3型,而单纯IgA型AIHA少见,常常直接抗人球蛋白试验（DAT）阴性。困扰着诊断和治疗。我们近期收治了1例单纯IgA型AIHA患者,现报道如下并进行文献复习。

Objective To genotype one patient with mixed-field agglutination in RhD antigen using serological tests,to identify patient's RhD phenotype,to infuse with same phenotype of RhD,and to explore the methods of laboratory detection and options of transfusion.Methods Serological tests and gene detection tests were used to identify RhD antigens in the patient.After determination of RhD phenotype,transfusion reactions were observed after infusion of identical RhD blood.Resuits From micro column gel chromatography and confirmation tests,patient's RhD antigens were confirmed to have characteristics from two phenotypes.IgM anti-D tube test determined that the sample had more than one mixed-field agglutination.Genotype was determined to be positive for RhD antigen.Multiple infusions of RhD positive blood did not result in production of anti-D antibodies.Conclusion Leukemia often causes weakening of RhD antigen.When serological tests cannot be used to confirm the phenotype,it can be complemented with genotyping.Upon determination of blood type,blood transfusion with blood of identical genotypes can be performed.

Objective:To compare the effects of transfusion for two AIHA patients who posses specific anti-D autoantibody and were transfused with red blood cells with perfect match or imperfect match and provide useful information for further study.Method:Erythrocyte antibody determinacy test,direct antiglobulin test(DAT),microcolumn gel test were used to screen matched red blood cells for transfusion for two AIHA patients.The level of hemoglobin,reticulocyte ratio,bilirubin and dissociated hemoglobin were measured before and after transfusion.Result:Our data showed that there was no transfusion reaction in AIHA patients posses specific anti-D autoantibody when transfused with perfect or imperfect matched red blood cells.Conclusion:AIHA patients with specific anti-D autoantibody could be transfused the RhD positive blood with weaker agglutination intensity when it is necessary.

OBJECTIVETo study the expression of specific anti- platelet glycoprotein autoantibodies GP II b/III a, GP I b/IX and GP I a/II a in primary immune thrombocytopenia (ITP), and to evaluate the relationship between the therapeutic effect and the expression of specific anti- platelet glycoprotein antibodies GPIIb/IIIa, GPIb/IX and GPIa/IIa.METHODSAnti-GPIIb/IIIa, GPIb/ IX and GP I a/II a antibodies were assayed by ELISA for patients with ITP. Total 442 patients in our hospital, who were retrospectively investigated from December 2010 to November 2012, were divided into newly diagnosed ITP, persistent and chronic ITP. The expression of specific anti- platelet glycoprotein antibody in each group was measured separately. The newly diagnosed ITP patients were treated with intravenous IgG (IVIG) and corticosteroids. The relationship between the expression of specific anti- platelet glycoprotein antibodies GPIIb/IIIa, GPIb/IX and GPIa/IIa and the complete response (CR) was studied.RESULTSPositive rates of anti- platelet glycoprotein antibodies were 59.09%, 26.97% and 37.35% respectively in newly diagnosed ITP, persistent and chronic ITP, the difference was statistical significant (P<0.05). In newly diagnosed ITP, positive rate of antibody against GPIIb/IIIa was 38.64%, double positive rate of antibodies against both GP II b/III a and GP I a/II a was 15.91%, there was statistical significance (P<0.05) compared with that of persistent and chronic ITP. The complete response (CR) rate in newly diagnosed ITP patients with positive antibody against GP II b/III a was 80.39% after treatment with IVIG and corticosteroids. There was statistical significance compared with that in patients having no antibodies (P<0.05).CONCLUSIONThe expression of antibodies against GP II b/III a and double positive for both GP II b/III a and GP I a/II a autoantibodies increased in newly diagnosed ITP patients. Patients with anti-GP II b/III a autoantibody had good response to medication with IVIG and corticosteroids.

<正>本院自1980年代开始,开展造血干细胞移植。在患者行异基因造血干细胞移植前对供者与受者进行ABO血型及Rh血型鉴定,自2003年2月开始我院使用Rh分型卡进行C、c、E、e抗原鉴定。由于卡上带有K抗原鉴定孔,因此在记录Rh血型的同时,观察并记录了K抗原在人群中的分布情况。至今共检测912例,发现1例K抗原阳性者,为造血干细胞移植正常供者,进一步对其进行家系调查,现报道如下。

输注血小板是各类血液病治疗过程中的常用支持疗法,在预防和治疗因血小板减少导致的出血中,具有重要临床意义.随着临床上对血小板输注后效果的日益关注,临床医生会为某些输注血小板后治疗效果欠佳的患者申请配型.

<正>真性红细胞增多症(polycythemia vera,PV)简称"真红",是1种获得性,源于造血干细胞的克隆性疾病,其特征为红细胞(RBC)造血异常增生,红系祖细胞对红细胞生成素高度敏感和非依赖[1]。PV患者最常用的疗法之一是放血治

OBJECTIVE:To investigate the complications and conversions in myeloproliferative disorders (MPD).METHODS:Three hundred and fifty six patients with MPD were reviewed, including 78 with etiologic thrombocythemia (ET), 93 with primary myelofibrosis (MF), 185 with polythythemia vera (PV). The clinical observation, follow-up, analysis with SPSS statistic software were performed.RESULTS:Out of the 356 cases, 101 (28.5%) developed thromboembolic events, 81 (22.8%) hemorrhage, 60 (16.9%) hypertension, 20 (5.6%) coronary heart disease, 3 (0.8%) hemolysis and 1 (0.3%) gastrointestinal ulcer, 2 (0.6%) calculus and 1 (0.3%) bone marrow necrosis. Twenty four patients (6.7%) developed MF (9 in ET, 15 in PV), 2 (0.6%) erythrocytosis (1 in ET, 1 in MF), 3 (0.8%) thrombocythemia (all in PV), 5 (1.4%) acute leukemia (2 in ET, 3 in MF) and 1 (0.3%) multiple myeloma (in ET). Eleven cases (3.1%) died, 5 (1.4%) from acute leukemia, 2 (0.6%) fatal hemorrhages, 1 (0.3%) each myocardial infarction and infectious shock, 2 (0.6%) unknown causes.CONCLUSION:Embolism and bleeding were the main complications in MPD. Conversions among ET, MF and PV hematological malignancies could occur.

目的:观察米托蒽醌(MTZ)治疗初治、复发急性白血病(AL)的临床疗效和毒副作用.探索以MTZ为主要药物作为一线治疗药物的可行性.方法:急性髓细胞白血病(AML)诱导治疗采用MTZ和阿糖胞苷(Ara-C).急性淋巴细胞白血病(ALL)诱导治疗采用长春新碱(VCR)、MTZ、异环磷酰胺(IFO)和强的松(Pred),条件允许时加用左旋门冬酰胺酶(L-ASP).结果:37例患者中29例取得完全缓解(CR),CR率78.4%.对20例AML患者进行了随访,治疗多于6疗程以上的10例患者,有8例持续CR(CCR),中位缓解期15.5月.结论:米托蒽醌联合用药治疗急性白血病有较好的疗效,其毒副作用可以耐受.该方案可以作为一线方案用于AL的诱导治疗.