Malcolm Needs

The +s stands for strongly expressed.

The expression of the P1 antigen varies considerably from person to person, but the reaction strength with anti-P1 is an inherited trait (i.e. the strength of the expression on the red cell surface).

"I apologize for this dumb question."  BBnoob69, NO QUESTION IS A DUMB QUESTION, IF YOU DO NOT KNOW THE ANSWER.  If you don't know the answer, the dumb thing is to not ask the question in the first place.  NEVER be afraid to ask a question on here,

The +s stands for strongly expressed.

The expression of the P1 antigen varies considerably from person to person, but the reaction strength with anti-P1 is an inherited trait (i.e. the strength of the expression on the red cell surface).

"I apologize for this dumb question."  BBnoob69, NO QUESTION IS A DUMB QUESTION, IF YOU DO NOT KNOW THE ANSWER.  If you don't know the answer, the dumb thing is to not ask the question in the first place.  NEVER be afraid to ask a question on here,

The +s stands for strongly expressed.

The expression of the P1 antigen varies considerably from person to person, but the reaction strength with anti-P1 is an inherited trait (i.e. the strength of the expression on the red cell surface).

"I apologize for this dumb question."  BBnoob69, NO QUESTION IS A DUMB QUESTION, IF YOU DO NOT KNOW THE ANSWER.  If you don't know the answer, the dumb thing is to not ask the question in the first place.  NEVER be afraid to ask a question on here,

The +s stands for strongly expressed.

The expression of the P1 antigen varies considerably from person to person, but the reaction strength with anti-P1 is an inherited trait (i.e. the strength of the expression on the red cell surface).

"I apologize for this dumb question."  BBnoob69, NO QUESTION IS A DUMB QUESTION, IF YOU DO NOT KNOW THE ANSWER.  If you don't know the answer, the dumb thing is to not ask the question in the first place.  NEVER be afraid to ask a question on here,

Hi Rich,

Yes you can, and, don't forget, under BSH Guidelines, you do not have to give blood that has been tested for the Cw antigen, if the unit is compatible by IAT with the patient's plasma/serum.  It is one of the few Rh antigens that can be given under these circumstances.

Be aware though, that I answer this in the knowledge that you are working in the Isle of Man (i.e. the UK).  This may not apply in other parts of the world (particularly Lithuania and Finland).

ALL Rh antibodies react with red cells treated with proteolytic enzymes, such as ficin, papain, trypsin and alpha-chymotrypsin (well, red cells that are expressing the cognate antigen, anyway), BUT, be careful because most monoclonal grouping reagents, including monoclonal anti-Cw, will often say to be used by either direct agglutination or by IAT, BUT NOT to be used with enzyme-treated red cells, because they can cause false positives.

Most of what I have written above can be found in Reid ME, Lomas-Francis C, Olsson ML.  The Blood Group Antigen FactsBook.  3rd edn, 2012. Academic Press.  ISBN: 978-0-12-415849-8.  The rest can be found in the manufacturer's insert, if the reagent is commercial.

Hope that helps, but feel free to get back if it doesn't.

The +s stands for strongly expressed.

The expression of the P1 antigen varies considerably from person to person, but the reaction strength with anti-P1 is an inherited trait (i.e. the strength of the expression on the red cell surface).

"I apologize for this dumb question."  BBnoob69, NO QUESTION IS A DUMB QUESTION, IF YOU DO NOT KNOW THE ANSWER.  If you don't know the answer, the dumb thing is to not ask the question in the first place.  NEVER be afraid to ask a question on here,

The +s stands for strongly expressed.

The expression of the P1 antigen varies considerably from person to person, but the reaction strength with anti-P1 is an inherited trait (i.e. the strength of the expression on the red cell surface).

"I apologize for this dumb question."  BBnoob69, NO QUESTION IS A DUMB QUESTION, IF YOU DO NOT KNOW THE ANSWER.  If you don't know the answer, the dumb thing is to not ask the question in the first place.  NEVER be afraid to ask a question on here,

The +s stands for strongly expressed.

The expression of the P1 antigen varies considerably from person to person, but the reaction strength with anti-P1 is an inherited trait (i.e. the strength of the expression on the red cell surface).

"I apologize for this dumb question."  BBnoob69, NO QUESTION IS A DUMB QUESTION, IF YOU DO NOT KNOW THE ANSWER.  If you don't know the answer, the dumb thing is to not ask the question in the first place.  NEVER be afraid to ask a question on here,

We have educated our multiple myeloma specialists to send a type and screen before administering the first dose of a daratumumab (Darzalex).  Our standard operating procedure is to have a panel of three cord blood cells (we have a large OB service) that is a laboratory developed test of sorts.  Cord cells do not express CD38 at interfering levels.
As it turns out we have made more of an issue of this than it warrants.  Patients who have negative antibody screens essentially never develop new antibodies to red cells after being started on daratumumab probably because it potential inhibits B cells function.  Minimal B cell function apparently yields little ability to make antibodies to red cell antigens, which are relatively weak alloantigens, especially when there is no adjuvant or inflammation in the recipient.  That said, a manufacturer is making a soluble CD38  analog that will inhibit the anti-CD38 activity and make testing easier from what I've read.  DTT treatment is also reasonable.  But the good news is that patients on this drug do not make new antibodies. There are literature references to this, and we have probably tested about 500 patients with no new alloantibodies. Mostly non-transfused patients, obviously.

Hi Rich,

Yes you can, and, don't forget, under BSH Guidelines, you do not have to give blood that has been tested for the Cw antigen, if the unit is compatible by IAT with the patient's plasma/serum.  It is one of the few Rh antigens that can be given under these circumstances.

Be aware though, that I answer this in the knowledge that you are working in the Isle of Man (i.e. the UK).  This may not apply in other parts of the world (particularly Lithuania and Finland).

Hi Rich,

Yes you can, and, don't forget, under BSH Guidelines, you do not have to give blood that has been tested for the Cw antigen, if the unit is compatible by IAT with the patient's plasma/serum.  It is one of the few Rh antigens that can be given under these circumstances.

Be aware though, that I answer this in the knowledge that you are working in the Isle of Man (i.e. the UK).  This may not apply in other parts of the world (particularly Lithuania and Finland).

ALL Rh antibodies react with red cells treated with proteolytic enzymes, such as ficin, papain, trypsin and alpha-chymotrypsin (well, red cells that are expressing the cognate antigen, anyway), BUT, be careful because most monoclonal grouping reagents, including monoclonal anti-Cw, will often say to be used by either direct agglutination or by IAT, BUT NOT to be used with enzyme-treated red cells, because they can cause false positives.

Most of what I have written above can be found in Reid ME, Lomas-Francis C, Olsson ML.  The Blood Group Antigen FactsBook.  3rd edn, 2012. Academic Press.  ISBN: 978-0-12-415849-8.  The rest can be found in the manufacturer's insert, if the reagent is commercial.

Hope that helps, but feel free to get back if it doesn't.

It is an honor to be here! I'm already learning so much from all of you! Thank you!!!🙏💕

It simply means that the P1 antigen is particularly strongly expressed on these red cell samples.  Therefore, if you come across a weak anti-P1, it may apparently react with these particular red cell samples, whilst apparently not with, for example, the third red cell sample shown in your antigram.  Although not identical to dosage, per se, it is fairly synonymous with dosage at a phenotypical level.
The strength of the expression of the P1 antigen is an inherited trait.

Welcome to this WONDERFUL site DLabGirl.  ENJOY!

I just answered this question.

My Score PASS  

Not happy with this.

IgE is unfolded at 56oC, but, that having been said, immunoglobulins are proteins, and ALL proteins are denatured/inactivated by high temperature.

Thanks Mabel for your explanation. I think we can exclude the protein factor.
1.In my work, I have noticed that the reagent cells express less H antigen than the donor cells do. Our screen and panel cells have 3-month shelf life, but our donor cells only have about 35 days. Even though we do our best to preserve the antigens on panel cells, there are still some losses. Of course, there are other antigen loss other than H.
2.I have read lewis antibodies may react with A type, sorry I can't recall it exactly, I will check it out after this work shift when I get home. If there is an anti-A Lewis antobody, it will react stronger with donor cells. As to the incompatible O donors, my bold guess is they express more Lewis antigen than reagent cells.
Sorry again for my imagination.

As an aside, I would suggest that an anti-G is almost certainly present, indeed, it may ONLY be an anti-G, with no or very weak anti-D and/or anti-C present, as the antibody is reacting stronger with the C antigen, than the D antigen.  This is a common finding with anti-G.

Turning to your real question, we have found in the past that people can have a "naturally occurring" antibody to an antibiotic added to the cell preservative by the manufacturers.  This is NOT easy to wash off from the reagent red cells, as they seem to adsorb it onto their surface almost as strongly as the Lewis antigens are adsorbed.  It could be that this patient has made just such an antibody, but this is a very tenuous explanation, and other members will probably come up with something a lot more probable!

I was thinking of antigens such as M, N, S, s, Fya, Fyb, Jka and Jkb.  However, they would only tell you if the patient is likely to be a chimera.

As far as what to give the patient, you are right in saying that these results would not help too much, if at all.

From what you have described, group A, D Positive cross-match compatible units should be fine.

I was thinking of antigens such as M, N, S, s, Fya, Fyb, Jka and Jkb.  However, they would only tell you if the patient is likely to be a chimera.

As far as what to give the patient, you are right in saying that these results would not help too much, if at all.

From what you have described, group A, D Positive cross-match compatible units should be fine.

I was thinking of antigens such as M, N, S, s, Fya, Fyb, Jka and Jkb.  However, they would only tell you if the patient is likely to be a chimera.

As far as what to give the patient, you are right in saying that these results would not help too much, if at all.

From what you have described, group A, D Positive cross-match compatible units should be fine.

I was thinking of antigens such as M, N, S, s, Fya, Fyb, Jka and Jkb.  However, they would only tell you if the patient is likely to be a chimera.

As far as what to give the patient, you are right in saying that these results would not help too much, if at all.

From what you have described, group A, D Positive cross-match compatible units should be fine.

Thanks for that Mabel Adams.

It may still be worthwhile having a karyotype performed as, in very unusual cases, a twin pregnancy can be completely absorbed into a single foetus, resulting in a single baby.

Are any other antigens showing mixed-field reactions?