The low-prevalence Rh antigen STEM (RH49) is encoded by two different RHCE*ce818T alleles that are often in cis to RHD*DOL

Authors

  • Marion E. Reid,

    Corresponding author
    1. From the Laboratory of Immunochemistry, New York Blood Center, New York, New York; the Laboratory of Immunohematology and Genomics, New York Blood Center, Long Island City, New York; the Rh Laboratory, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada; and the Specialized Laboratory Services, South African National Blood Service, Pinetown, KwaZulu-Natal, South Africa.
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  • Christine Halter Hipsky,

    1. From the Laboratory of Immunochemistry, New York Blood Center, New York, New York; the Laboratory of Immunohematology and Genomics, New York Blood Center, Long Island City, New York; the Rh Laboratory, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada; and the Specialized Laboratory Services, South African National Blood Service, Pinetown, KwaZulu-Natal, South Africa.
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  • Kim Hue-Roye,

    1. From the Laboratory of Immunochemistry, New York Blood Center, New York, New York; the Laboratory of Immunohematology and Genomics, New York Blood Center, Long Island City, New York; the Rh Laboratory, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada; and the Specialized Laboratory Services, South African National Blood Service, Pinetown, KwaZulu-Natal, South Africa.
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  • Gail Coghlan,

    1. From the Laboratory of Immunochemistry, New York Blood Center, New York, New York; the Laboratory of Immunohematology and Genomics, New York Blood Center, Long Island City, New York; the Rh Laboratory, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada; and the Specialized Laboratory Services, South African National Blood Service, Pinetown, KwaZulu-Natal, South Africa.
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  • Coral Olsen,

    1. From the Laboratory of Immunochemistry, New York Blood Center, New York, New York; the Laboratory of Immunohematology and Genomics, New York Blood Center, Long Island City, New York; the Rh Laboratory, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada; and the Specialized Laboratory Services, South African National Blood Service, Pinetown, KwaZulu-Natal, South Africa.
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  • Christine Lomas-Francis

    1. From the Laboratory of Immunochemistry, New York Blood Center, New York, New York; the Laboratory of Immunohematology and Genomics, New York Blood Center, Long Island City, New York; the Rh Laboratory, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada; and the Specialized Laboratory Services, South African National Blood Service, Pinetown, KwaZulu-Natal, South Africa.
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  • This study was supported in part by Grant NIH HL091030 (CHH, MER, KHR) and the Winnipeg Rh Institute Foundation (GC).

Marion E. Reid, PhD, Laboratory of Immunochemistry, New York Blood Center, 310 East 67 Street, New York, NY 10065; e-mail: mreid@nybloodcenter.org.

Abstract

BACKGROUND: STEM (RH49) is a low-prevalence antigen in the Rh blood group system. A scarcity of anti-STEM has precluded extensive study of this antigen. We report that two alleles with a RHCE*ce818C>T change encode a partial e, and a hrS−, hrB+, STEM+ phenotype and that both alleles are frequently in cis to RHD*DOL1 or RHD*DOL2.

STUDY DESIGN AND METHODS: Blood samples were from donors and patients in our collections. Hemagglutination, DNA, and RNA testing was performed by standard techniques.

RESULTS: Fourteen STEM+ samples were heterozygous RHCE*ce818C/T: six had RHCE*ceBI and eight had a novel allele, RHCE*ceSM. Eleven were heterozygous for RHD*DOL1 or RHD*DOL2. Eleven samples, previously typed STEM−, had RHCE*ce818C/C (consensus nucleotide). RBCs from informative STEM+ samples were e+/− hrS− hrB+. One person who was heterozygous RHCE*ceBI and RHCE*cE had an anti-e-like antibody in her plasma, and one person, who was hemizygous for RHD*DOL2, had anti-D in her plasma.

CONCLUSIONS: We show that two alleles with a RHCE*ce818C>T change (RHCE*ceBI and RHCE*ceSM) encode a hrS− hrB+ STEM+ phenotype. In addition, both alleles are frequently in cis to RHD*DOL1 or RHD*DOL2 and RHCE*ceBI encodes a partial e antigen. In the small cohort of samples tested, RHD*DOL invariably traveled with RHCE*ce818T. Our study also confirmed the presumption that RHD*DOL2, like RHD*DOL1, encodes a partial D antigen and the low-prevalence antigen DAK.

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