[Rh-prophylaxis or not? Obstetric departments should make decisions if there are medical reasons which justify the treatment]. / Rh-profylax eller ej? Kvinnoklinikerna bör själva avgöra om medicinska skäl motiverar behandlingen.

In order to find out whether or not the incidence rate of RhD-immunization has increased in pregnant women who were not given antenatal prophylaxis a survey was carried out comprising 620 women. It was evident that the number of new immunizations had decreased, both in absolute numbers and in relation to the number of births during the years 1991-1998. Hence prophylactic anti-D seems not to be indicated, neither for this group of women nor for women who have had a spontaneous abortion.

[Transfusion medicine--Scandinavian recommendations]. / Transfusionsmedicin--nordiske rekommandationer.

At the 14th Nordic Congress on Transfusion Medicine, held in Reykjavik in 1993, it was recommended that every blood bank should have an established programme for the management of screening-positive donors and blood components deriving from them. Other topics discussed at the congress were the education of registrars in transfusion medicine, new screening methods and questions of quality assurance.

Monoclonal antibodies produced by immunization with neoglycoproteins containing Gal alpha 1-4Gal beta 1-4Glc beta-O and Gal alpha 1-4Gal beta 1-4GlcNAc beta-O residues: useful immunochemical and cytochemical reagents for blood group P antigens and a differentiation marker in Burkitt lymphoma and other B-cell malignancies.

Several monoclonal antibodies (MAbs) directed to blood group P1 (Gal alpha 1-4Gal beta 1-4GlcNAc beta-O) and Pk (Gal alpha 1-4Gal beta 1-4Glc beta-O) determinants were produced with high efficiency by using synthetic neoglycoproteins as immunogens. The specificity of IgM and IgG1 MAbs was characterized by binding to defined oligosaccharides and glycoconjugates. Antibodies that bound equally well to P1 and Pk determinants and to Gal alpha 1-4Gal beta 1-O-derivatives were obtained, together with others that showed selective recognition of the entire trisaccharide chain. Selected antibodies were shown to be useful as reagents for detection of the blood group P antigens in glycolipid extracts of erythrocytes and on the surface of erythrocytes of different P phenotypes, demonstrated both by radioimmune assays and hemagglutination. Six IgM MAbs directed to the Pk determinant bound selectively to Burkitt lymphoma cells and 2 of these antibodies (424/3D9 and 424/6A2) could be used as auxiliary reagents in immunofluorescence for diagnosis and classification of B-cell lymphomas and leukemias using flow cytometric analysis. Eight normal individuals and 37 patients with lymphoma or leukemia were studied. Tumor cells of 2/2 patients with "Burkitt-like" lymphoma, 1 patient with centroblastic lymphoma and 2 patients with acute leukemia were strongly stained for the Pk antigen. The staining patterns for differentiation markers classified the tumor cells to a developmental stage closely related to the Burkitt cell type.

A monoclonal anti-glycophorin A antibody recognizing the blood group M determinant: studies on the subspecificity.

A mouse monoclonal antibody (425/2B, IgM) was obtained which shows specificity for blood group M determinant of glycophorin A. The antibody is pH-dependent. At pH 6-7 it reacted strongly with blood group M antigen, but also cross-reacted distinctly with N antigen. At pH 8.3 the antibody showed moderately decreased reactivity with M antigen, but no interaction with N antigen was detectable by hemagglutination, immunoblotting, or microplate ELISA. The direct binding studies and inhibition of 425/B antibody by untreated or modified blood group M and N glycoproteins or tryptic glycopeptides showed that the binding to the antigens was not affected by acetylation of their amino groups, or removal of amino-terminal amino acid residue. Desialylation of the antigens decreased their reactivity with the antibody and this effect was distinctly stronger at pH 7 than 8.3. The antibody reacted strongly at pH 7 and 8.3 with glycophorin B of Henshaw phenotype, whereas its reactivity with normal glycophorin B was weak or undetectable at these pH values, respectively. The results obtained indicated that anti-M specificity of 425/2B antibody is related to the 5th amino acid residue of glycophorin A (anti-Mgly specificity) and that pH shift from 7 to 8.3 changes the fine specificity of the antibody. At pH 8.3 the reactivity of the antibody is more dependent on glycine residue (higher anti-M specificity) and less dependent on sialic acid residues in the antigen.

Immunochemical characterization of a monoclonal anti-Leb blood grouping reagent.

A haemagglutinating monoclonal anti-LebL antibody has been obtained from a mouse-mouse hybridoma after immunization with the Leb-active oligosaccharide lacto-N-difucohexaose I, coupled to edestin. Of 13 other antibodies obtained, one was able to agglutinate enzyme-treated erythrocytes of all ABO groups and three more were considered to be anti-LebH haemagglutinins. The remaining nine antibodies did not agglutinate red cells. The specificity of the stronger of the anti-LebL haemagglutinins was examined by studying its binding to a number of glycoconjugates and oligosaccharides.

Mouse monoclonal antibodies with anti-A, anti-B and anti-A,B specificities; some superior to human polyclonal ABO reagents.

A series of fusions using mouse myeloma cells and spleen cells from mice immunized with blood group substances or human red cells was performed with the aim of obtaining ABO antibodies suitable for routine blood grouping. Seven strongly agglutinating antibodies against antigens in the ABO system were obtained from 18 fusions. These antibodies were tested extensively in manual and automated routines, and six of them were found to be as good as or better than commercial polyclonal test sera of human origin.

Screening of Rh-antibodies in Rh-negative female infants with Rh-positive mothers.

The sera of 96 consecutive Rh-negative female infants born to Rh-positive mothers were examined at birth, and sera from 88 of these infants were examined for the presence of Rh-antibodies at the ages of about three and eight months. A two-stage papain test and an AutoAnalyzer method were used for antibody screening and identification. Weak anti-D antibodies were found by the papain and AutoAnalyzer techniques in two cord sera, In neither case could the antibodies be demonstrated in samples taken on later occasions. Weak anti-D antibodies were found by the AutoAnalyzer technique but not by the manual methods in the sera of two other infants at the age of eight months. These antibodies could still be demonstrated by the same technique in samples taken about one month later. Though far from conclusively, the results support the "grandmother theory", but because of the low incidence of sensitization and uncertain nature of the anti-D antibodies demonstrable only by the AutoAnalyzer technique, anti-D prophylaxis is not recommended for newborn Rh-negative female infants with Rh-positive mothers.

Urinary excretion of oligosaccharides induced by galactose given orally or intravenously.

The effect of oral administration of galactose, lactose, and sucrose and intravenous injection of galactose on the urinary excretion of blood-group-active oligosaccharides has been studied. Galactose given either as the free sugar, a glycoside (lactose) or a constituent of normal diet was an absolute requirement for the formation and excretion of A-trisaccharide, B-trisaccharide and 2'-fucosylgalactose in blood group A, B and O(H) secretors, respectively. Great individual variation was seen in the amounts of galactose-dependent oligosaccharides excreted. Injection of galactose resulted in excretion of 3-59% of the amount of oligosaccharide formed after oral administration to the same individual. The mean ratio A-trisaccharide/B-trisaccharide was 2.7 in four blood-group-A1B secretors and 0.22 in three A2B secretors and can thus serve as a parameter for chemical differentiation between the two blood groups. The excretion of larger blood-group-active oligosaccharides, including the A-pentasaccharide, the B-pentasaccharide and lactodifucotetraose, that are normal components in urine from, respectively, starved A, B, and H secretors, was about the same after oral administration of galactose or lactose. The B-trisaccharide was the only oligosaccharide detected in plasma after oral galactose administration to a blood-group-B secretor individual. The concentration was 0.38 mg/l of plasma.

Automated blood grouping of patients and blood donors using Groupamatic 360 S and a separate mini-computer. System description and evaluation.

An automated blood-grouping system for all kinds of blood samples is described. The system is built upon Groupamatic 360 S and a separate mini-computer. Both the laboratory and the clerical work is automated. Blood group replies are given on coloured punch cards in the Scandinavian blood group colours. Lists of different groups of samples can be compiled. After 1 year of routine use, the refusal rate is about 5%. The system is reliable and rapid, and permits saving, both of manpower and reagents.