"HTLA" antibodies

[Dawn]

How do you deal with antibodies that appear to be antibodies that were formally called HTLA antibodies?

If the antibody has a pattern that suggests a high-frequency antibody of any specificity, we fully phenotype the patient. Then we test the patient's plasma with Ficin and DTT treated cells. We have a flow chart that gives some suggestions based on the results. In cases of "HTLA" antibodies when the ruling out gets particularly difficult we will do adsorption/elution studies, assuming that the "HTLA" antibody will not adsorb out. We choose a cell for adsorption that exhibits all of the antigens that the patient lacks. Then we will do an antibody screen on the eluate. Usually we do not bother to rule out anti-K and anti-E since it is difficult to find K+ and E+ cells for adsorption.

Does anyone know of a better way to deal with these particularly difficult workups?

[Melanie]

titer a phenotypically matched cell, see if it acts like a HTLA.

If it does and you are unable to rule-out, then you should do absorptions and elutions. The use of DTT and enzyme techniques can help you decide what raw antiseras to use to test patient cells and what cells you wish to thaw for additional testing. Sometimes you just get lucky....... We use a flowchart based on reactions with different enhancement techniques and try and follow it as best as we can. But, as we all know, the antibodies do not read the books!!!!! :| :mrgreen:

[la66]

run 2 phenotypically matched cells, if it is still positive then titer them. If titer is >=32 then we call HTLA. I have worked in a reference lab that always tried to id the antibody. That is when it becomes necessary to run ficin/DTT and helpful to know the race. We also tested the antibody ito see if it was neutralizable with pooled serum for Ch/Rg. We then typed the patient

for Vel, Lub and Kpb all high incidence abys that can titer just to rule them out.