TY - JOUR T1 - ABO Discrepancy in a Multiple Myeloma Patient: A Case Study JF - American Society for Clinical Laboratory Science JO - Clin Lab Sci SP - 204 LP - 207 DO - 10.29074/ascls.15.4.204 VL - 15 IS - 4 AU - Jo Ann Wilson AU - Angel Jacobs Y1 - 2002/10/01 UR - http://hwmaint.clsjournal.ascls.org/content/15/4/204.abstract N2 - The hospital transfusion services received an order for three units of red blood cells for a 45-year-old Caucasian male. His most recent hematological study revealed a hemoglobin level of 7.0 g/dL (Table 1). Blood was obtained from the patient and the clinical laboratory scientist (CLS) proceeded with pre-transfusion testing of phenotype and antibody screening. The results of the forward typing of ABO and Rh indicated that the patient was phenotype A Rh positive (Table 2). However, a discrepancy was found in the reverse typing with A1 cells and B cells producing agglutination. Using antibody-screening cells, the patient's serum was tested. The results indicated agglutination upon immediate spin, but no agglutination in subsequent testing including 37 °C with LISS enhancement (Table 3).The CLS requested additional history on the patient. The diagnosis was multiple myeloma; there had been no previous transfusions.DISCUSSION Multiple myeloma is a hematological malignant neoplasm of the bone marrow. It is a neoplastic disease characterized by the infiltration of bone and bone marrow by myeloma cells forming multiple tumor masses.1 Production of normal immunoglobulins is impaired with a significant increase in the number of abnormal plasma cells.2 The condition is usually progressive and generally fatal. The disease causes pain, fractures, anemia, hypercalcemia, kidney failure, bacterial infections, nerve compression with paralysis, skeletal deformities, and changes in mental status ranging from mild to severe confusion.3, 4 According to the American Cancer Society, about 14,400 new cases will be diagnosed and about 11,200 Americans are expected to die of multiple…ABBREVIATIONS: AHG = anti-human globulin; LISS = low-ionic strength solution. ER -