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New National Center Aims to Expand Use of Genomics for More Accurate Blood Typing


NEW YORK (GenomeWeb) – Under the leadership of Connie Westhoff, the New York Blood Center — along with its partner center, the Community Blood Center of Greater Kansas City —plan to open a new National Center for Blood Group Genomics with the goal of improving the accuracy of blood typing in the matching of transfusion donors and recipients.

Speaking with GenomeWeb this week, Westhoff, the NYBC's director of immunohematology, genomics, and rare blood, said the NYBC and its Missouri partner are still in the planning stages of launching the new center, which will be located in Kansas City.

"We don't have the site yet, but we are ready with the funding, and we hope to have the new national center up and running by the end of the year," she said.

According to Westhoff, the choice to locate the new center in Kansas City reflects a commitment the NYBC made to its partner center when the two merged in 2014 to work on elevating the level of medical care and treatment in the area. The decision also rested on the obvious benefit of locating a nationally oriented center in the middle of the country, not to mention the more obvious cost savings and practicality of operating in Missouri as opposed to NY.

The 2014 merger of the Kansas City CBC with NYBC reflects an overall shift in the blood transfusion space, as medical practice has evolved to require fewer transfusions for patients, overall, and as the sourcing and matching of blood donations has become much less regional.

"It used to be that blood centers served only a local community, and that's where the blood stayed, but now blood transfusion services are nationwide," Westhoff said.

With the new center, the partners hope to open up broader national access to a new generation of blood type analyses using genomic technologies, including array-based testing and next-gen sequencing.

"We have been matching patients with donors using A, B, O, Rh positive, and Rh negative since the 1950s – but there are over 300 other blood group antigens," Westhoff explained.

"What happens if you don't address these other factors," she asked. "Is that at least three percent [of those] getting a single blood transfusion to as many as 50 percent needing chronic transfusion can have an immune reaction, which makes … each subsequent transfusion more difficult."

In the new center, both array-based and NGS approaches will play a role in greatly increasing the precision of antigen testing and donor-recipient matching, Westhoff said, though the details of the center's molecular testing strategy are not yet fully defined.

Only one SNP genotyping chip — the Precise Type HEA assay, developed by Immucor — has received US Food and Drug Administration approval for clinical use, but other techniques have also been developed and implemented in blood-typing labs.

The NYBC was an early RUO user of the Immucor chip, and Westhoff oversaw the clinical trial of PreciseType HEA that was included as part of the company's FDA submission. According to the NYBC's website, the methods currently in use by the center's genomics lab include DNA array, PCR-RFLP, AS-PCR, and gene-specific amplification and sequencing.

In the March issue of the journal Transfusion, Westhoff and colleagues also published a proof of principle study on comprehensive antigen prediction from whole-genome sequencing data, something she said her team hopes to continue to research under the banner of the new national center.

With a shift from traditional serology to more detailed genomic analysis, the need for de-localization and nationalization becomes even more acute, Westhoff said, because having more precise criteria for matching means that the best match for any one patient is much less likely to be a local one.

The new center plans to offer genomics-based blood antigen testing for both medical facilities and also for other blood centers nationwide who don't have their own in-house genomics capabilities, aiming for about a 24-hour turnaround, Westhoff said.

While some other blood centers have begun to adopt genomics for more precise blood group testing in recent years — for example, Bloodworks NW and the University of Washington, which recently designed a 42-gene NGS panel that they are evaluating in comparison to array-based SNP genotyping — these early adopters represent only a handful of blood centers across the US.

"The idea here is economy of scale, to be able to lead in development of these approaches and serve as centralized lab," Westhoff explained.

In addition to implementing both array-based and NGS-based antigen testing, the center is also working on developing algorithms to translate existing genetic data, from whole-exome or whole-genome sequencing, perhaps, into a blood group profile, anticipating a future where patients may more frequently have existing sequencing data as a part of their medical records.

Finally, outside of the transfusion space, Westhoff said the new center will also have an adjunct focus on applying genomics in the blood typing of pregnant women, as a way of more precisely determining which women are candidates for immunoglobulin therapy.