Molecular genotyping versus serological diagnosis for RH blood group typing in sickle cell patients

ABSTRACT

Objectives

High rate of alloimmunization in sickle cell disease (SCD) patients poses a significant challenge in finding compatible blood unit. Accurate determination of the blood group genotype of them can help reduce the alloimmunization risk. Tetra ARMS PCR is a novel method that has been utilized recently to investigate SNPs in diseases in a fast and reliable way.

Methods

Our study included 104 SCD and sickle thalassemia (Sβ) patients referred to Baghaei-2-Hospital of Ahvaz in 2019 using a nonrandom sampling method. Blood samples were collected for serological and molecular tests. Rh genotyping was performed using Tetra ARMS PCR and compared with the serological results.

Results

Based on the Tetra ARMS PCR method, out of 104 patients, 7 (6.7%) were d/d, 40 (38.5%) were D/d, 57 (54.8%) were D/D, 25 (24%) were C/C, 59 (56.7%) were C/c, 20 (19.3%) were c/c, 4 (3.8%) were E/E, 25 (24%) were E/e, and patients 75 (72.2%) were e/e. There were discrepancies in the serological and molecular results for 11 patients.

Conclusion

Use of Tetra ARMS PCR in combination with serological methods for determining the Rh blood group system in donors and transfusion-dependent patients represents a remarkable transformation in the field of immunohematology.

KEYWORDS:

• Alloimmunization
• Blood transfusion
• Genotype
• PCR
• Phenotype
• Sickle cell disease

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Article highlights

• The study found discrepancies between serological and molecular methods in determining the genotype of RH in 11 out of 104 patients.

• The discrepancies are probably due to weak or cross reactions in serological methods.

• Molecular methods using DNA analysis can overcome limitations of serological methods in determining blood type, especially in transfusion-dependent patients.

• Further studies on important polymorphisms of RH system be conducted using the Tetra ARMS-PCR method is recommended.

Declaration of Interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Ethics Statement

In this study, the satisfaction of all the participants was checked by an informed consent form, and all the people who participated in the study signed this form. Additionally, all information related to patients and the control group was confidential. Ethics approval was obtained from the medical ethics committee of the Higher Educational Institute of Blood Transfusion, Tehran, Iran.

Author Contributions

MA Jalali Far and Z Eftekhar wrote the main manuscript text. M Mohammadipour, B Keikhaei and N Amirizadeh were involved in the study design and methodology and A Oodi prepared figures. All authors reviewed the manuscript.

Additional information

Funding

This paper was not funded.