Winnie

Malcolm,
thanks for your feedback- my sentiment exactly, I don’t see the point of restricting transfusion with only Group O red cells- it seem unnecessary. Some laboratories here in Oz are too cautious, our standards/guidelines mention exactly what you’ve stated, unless there is an allo-anti-A1 active at 37, the requirement is IAT compatible crossmatch (so A2 transfusions would suffice).
Interesting to hear about your experience with loss of A or B antigen and AML! I’ve only seen cases with AML as well , not ALL. Publications also only mention myeloid leukaemias. You’ve inspired me to follow through with another patient of ours and their progress. 🙂

Malcolm,
thanks for your feedback- my sentiment exactly, I don’t see the point of restricting transfusion with only Group O red cells- it seem unnecessary. Some laboratories here in Oz are too cautious, our standards/guidelines mention exactly what you’ve stated, unless there is an allo-anti-A1 active at 37, the requirement is IAT compatible crossmatch (so A2 transfusions would suffice).
Interesting to hear about your experience with loss of A or B antigen and AML! I’ve only seen cases with AML as well , not ALL. Publications also only mention myeloid leukaemias. You’ve inspired me to follow through with another patient of ours and their progress. 🙂

There is absolutely no reason to give group O red cells to a recipient who is A3.  Even if the patient does develop an anti-A1, unless that antibody is reactive at strictly 37oC, they can still receive A1 red cells, but, if the anti-A1 does react at 37oC, there is no reason not to transfuse with A2 red cells that are IAT compatible.
Personally, I have never seen loss of A or B antigens through ALL, but I have with AML.  In fact, in one case, we were able to follow whether the patient was in remission or relapse by the strength of the reaction of the A antigen with various anti-A reagents, but this was many years ago, and I honestly can't remember whether these were human-derived polyclonal reagents or early monoclonal reagents.

Thanks all! Hello from Down Under!
Looking forward to learning and connecting with everybody across the world. 

Thanks all! Hello from Down Under!
Looking forward to learning and connecting with everybody across the world.