{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T21:07:51Z","timestamp":1773004071019,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Despite red blood cell (RBC) immunization being a frequent complication of chronic transfusion in myelodysplastic syndromes (MDS), its prognostic significance remains unclear. We analysed 486 transfused patients diagnosed with MDS. Prognostic impact of RBC immunization (allo\u2010 or autoantibodies) was evaluated as a time\u2010dependent covariate. Competing risk methods were applied to estimate the cumulative incidence of immunization. Sixty\u2010nine patients (14.2%) developed RBC immunization, most commonly anti\u2010K and anti\u2010E, which was more frequent in patients transfused before MDS diagnosis (subhazard ratio [SHR]: 2.9, 95% confidence interval [CI]: 1.6\u20135.4;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001) and Rh(D)\u2010negative blood group (SHR: 1.9, 95% CI: 1.1\u20133.2;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.026). RBC immunization was associated with a significant and independent reduction in remaining survival (hazard ratio: 11.9, 95% CI: 7.3\u201319.6;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001), without differences between auto\u2010 and alloantibodies. RBC immunization was followed by increased transfusion intensity, but transfusion requirements also rose in non\u2010immunized patients over time. RBC immunization did not predict progression to acute myeloid leukaemia (AML). A trend towards fewer new antibodies was observed during hypomethylating therapy. RBC immunization is independently associated with reduced survival in transfusion\u2010dependent patients with MDS, irrespective of AML progression. These findings highlight the potential prognostic relevance of RBC antibodies and call for further investigation into the mechanisms linking immunization, transfusion burden and survival outcomes.\n                  <\/jats:p>","DOI":"10.1111\/bjh.70330","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T07:27:37Z","timestamp":1768980457000},"page":"697-704","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Red blood cell immunization as an independent predictor of survival in the myelodysplastic syndromes"],"prefix":"10.1111","volume":"208","author":[{"given":"Alexandra","family":"Pedraza","sequence":"first","affiliation":[{"name":"Banc de Sang i Teixits\u2014Hospital Cl\u00ednic  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Casta\u00f1o","sequence":"additional","affiliation":[{"name":"Hematopathology Section, Department of Pathology Center for Biomedical Diagnosis, Hospital Cl\u00ednic  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arturo","family":"Pereira","sequence":"additional","affiliation":[{"name":"Transfusion Service, Center for Biomedical Diagnosis, Hospital Cl\u00ednic  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meritxell","family":"Nomdedeu","sequence":"additional","affiliation":[{"name":"Section of Hemostasis, Cancer and Hematology Diseases Institute, Hospital Cl\u00ednic  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Ruiz","sequence":"additional","affiliation":[{"name":"Information Systems, Center for Biomedical Diagnosis, Hospital Cl\u00ednic  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Esteva","sequence":"additional","affiliation":[{"name":"Banc de Sang i Teixits\u2014Hospital Cl\u00ednic  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"D\u00edaz\u2010Beya","sequence":"additional","affiliation":[{"name":"Hematology Department Hospital Cl\u00ednic  Barcelona Spain"},{"name":"Grupo Espa\u00f1ol de S\u00edndromes Mielodispl\u00e1sicos (GESMD) Fundaci\u00f3 de Recerca Cl\u00ednic\u2010Institut d'Investigacions Biom\u00e8diques August Pi I Sunyer (FRCB\u2010IDIBAPS)  Barcelona Spain"},{"name":"Josep Carreras Leukemia Research Institute  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0370-3436","authenticated-orcid":false,"given":"Cristina","family":"Sanz","sequence":"additional","affiliation":[{"name":"Transfusion Service, Center for Biomedical Diagnosis, Hospital Cl\u00ednic  Barcelona 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