Antibodies?

[LynnI]

In my searches I haven't been able to find this answer (and frankly keep forgetting to ask my doc.)

Does anyone know if Anitbodies once developed from tx's go away given enough time? Or am I stuck with them?

Thanks in advance
Lynn

[Birgitta-A]

Hi Lynn,
As far as I understand the antibodies against RBC:s won´t disappear.

I developed antibodies very soon after my first transfusions. It takes hours to find blood that I can have because of all my antibodies. To prevent hemolysis I always get 100 mg Solucortef (cortison) before transfusions but I don´t think it has much effect.

http://www.merck.com/mmpe/sec11/ch131/ch131b.html
Kind regards
Birgitta-A
71 units of packed RBS:s since May 2006

[Lisa V]

Lynn,

It is my understanding also that they don't go away on their own.

I don't know how many of you here have been following Grant Beltrami's BMT, but he rejected his first graft because of antibodies to his donor's marrow. To remedy that, they did a process of plasma pheresis, where his plasma (which presumably contained the antibodies) was removed and replaced with albumen. Then they were able to try again with the same donor. I think I have that right; if not, perhaps Ruth can correct me. At any rate it sounds like a fairly radical procedure to me. I don't know if anything like that is ever done outside of a transplant setting, but it certainly isn't routine.

[LynnI]

Thanks for the responses.

Your confirming what I thought was true. My antibodies had developed before I was dx and my MDS doc made a face, when he found out about them, stating that wasn't good esp. for any future BMT's...........

Thanks again.
Lynn

[squirrellypoo]

Lynn, it's not great for BMTs, but it's not impossible. Because of all my transfusions when I was little in addition to the ones I've had in the past few months, I've got antibodies against pretty much all the platelets out there.

The regular pools (from lots of donors) stopped working about a month ago, even with the dose of piriton first to stop any reactions, then they swtched me to single-donor platelets and I wasn't incrementing on those either, and just last week they ordered some HLA-matched platelets for me. The first didn't take at all (my platelet count an hour afterwards was the same as before), but a different bag of HLA platelets on Tuesday worked great.

I'm getting my BMT in less than a fortnight, so I know it's more work and coordination for the hospital to organise HLA-matched platelets for me for the duration of my stay, but it hasn't even pushed back my admission date or anything...

[JEZ]

Hi Everyone,

Is it true that irradiating the transfusions prevents antibodies from forming? This is what my doctor told me when I started receiving transfusions and she told me she always ordered my platelets, etc irradiated. I am hoping this is one problem I managed to avoid just in case I need to consider transplant in the future .... thanks!

JEZ

[Neil Cuadra]

Yes, it's true. Irradiation and leukocyte-reduction of blood products can reduce the chances of transfusion rejections and bad reactions. This is especially important for patients who are immunocompromised and receiving frequent transfusions.

[BBTALKER]

Antibodies produced in response to a foreign antigen, do not go away. They sometimes lose titer( strength) and may be below a detectable limit. Every blood bank will continue to give negative blood for the corressponding antigen as long as they have the information available. If you have been told you have certain antibodies, I suggest you keep a card or list on your person and give it to a hospital or keep it in your wallet, so the infromation can be passed to the Transfusion Service. Although they will always perform their own work-up, the infromation can be invaluable.

[BBTALKER]

Blood can be ordered several ways, depending on the diagnosis of the patient and the physicians requirements. Leuko reduction of a unit of blood removes WBC or white cells down to < 5X106 wbc. This decreases the wbc and reduces the chance of a febrile reaction due to some of the inflammatory products produced by the cells. It also reduces HLA alloimmunization to HLA antigens. This can be beneficial in those receiving multiple transfusions.
Thereis also CMV or cytomegalovirus. This can be devatatiing to those suffering from an immunocomprised sytem, so typically a MD may order CMV negative products fro these patients. Irradiation , again used in the immunocomprimised patient reduces graft vs host disease and is not a typical order for a routine tranfusion not associated with stem cell tranplantation, etc..