Abstract: Objective To compare detection capabilities between flow cytometry and a conventional serological method to develop a more sensitive and reliable technique for clinical pre-transfusion detection of autoimmune hemolytic anemia patients. Methods We used the plasma samples collected from autoimmune hemolytic anemia patients simulated with human-derived autoantibodies and alloantibodies. Common clinically significant antibodies were selected, and 5 cases of anti-D and 4 anti-E were mixed with the autoantibodies in proportion to prepare autoimmune hemolytic anemia patients' plasma samples. The gel card method and flow cytometry were used to detect the above-mentioned simulated plasma, respectively. Results In 3 titer groups (16, 32 and 64), the sensitivity of flow cytometry was significantly stronger than that of the gel card method, and the detection limit was 4 times that of the gel card method (P<0.05). Conclusion Compared with the traditional serological method, flow cytometry has higher sensitivity for the detection of alloantibodies under the cover of autoantibodies. Application of this method for the pre-transfusion examination of autoimmune hemolytic anemia patients can reduce blood transfusion risks mediated by the same antibody and improve the safety of blood transfusion among them.

Key words: Autoimmune hemolytic anemia, Autoantibodies, Blood group alloantibodies, Flow cytometry, Serological methods