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Aim Case: 36 year old female with AML diagnosed in Dec 2011 and persistent disease after 3 rounds of chemotherapy. She received 7 granulocyte transfusions for neutropenic sepsis in Dec 2011. Single antigen bead (SAB) testing in Jan 2012 demonstrated alloimmunization to HLA-DPB1. Patient has one mismatched sibling and unrelated search was initiated. She demonstrated donor specific antibodies (DSA) to all donors. We present here the progression of DSA over a 5 month period and the clinical care based on these DSA. Methods Confirmatory typing of 5 donors found that 2 were 10/10 match with the recipient, while 3 were mismatched at DQB1. Since the recipient demonstrated DP antibodies with MFI >1000, DPB1 typing was performed on the recipient and donors. Results Recipient and donor DPB1 typing and DSA are summarized [ Table 1 ]. Serial SAB demonstrate decreasing MFI with no specific DSA reducing intervention and reflected in B-FXM with donor-2 cells [ Table 2 ]. Based on the high DSA levels, an autologous bone marrow harvest was performed as backup to allotransplant. As the DSA MFI was Conclusions DPB1 antibodies are known to play a role in graft rejection. We present a case of alloimmunization to HLA-DPB1 antibodies following granulocyte transfusion and with decreasing MFI after discontinuation of transfusion. Post transplant DPB1 antibody levels and clinical outcome will be presented at the meeting.

Aim HLA-B27 (associated with ankylosing spondylitis, juvenile rheumatoid arthritis, and Reiter’s syndrome) can be detected utilizing the BD (Becton Dickinson Biosciences) HLA-B27 system with monoclonal antibodies. This is a qualitative two-color direct immunofluorescence flow cytometric method for rapid detection of the cell-surface glycoprotein expressed on most nucleated human cells. Publications have reported the BD system cross-reacts with several HLA-B antigens. However, these have been based on a limited sample size. Our laboratory performs approximately 24,000 test per year; therefore, we present an overview of our data from 2011. Methods Samples are tested with the BD kit monoclonal antibody GS145.2. Flow cytometric results falling in the gray zone are confirmed using SSO typing assay. In our laboratory 5% (1,123 specimen) tested in 2011 fell into our defined gray zone. Results Analysis of our 2011 data confirmed the presence of published HLA-B27 cross-reactive antigens [ Table 1 ]. We observed additional reactivity with the following HLA-B antigens in the absence of the published antigens [ Table 2 ]. Majority of the times these occurred in combination with a known cross-reactive group. Conclusions This leads us to consider additional potential cross-reactive antigens. Further analysis of this data and additional data collected in 2012 will be needed to support and verify additional reactivity observed.

with ID. Conclusions: ID is highly prevalent in hospitalized HF patients and is associated with lower glucose and creatinine and higher albumin level. Based on our study model, iron deficiency didn’t correlate with outcomes pertaining to both in-hospital and all-cause mortality. There were no significant clinical indicators to suggest ID and thus iron values should be routinely measured in hospitalized patients with HF.