Red blood cell (RBC) antigens represent inherited traits and as such, their expression should be constant throughout the life of an individual. We describe a patient in whom the expression of the Rh D and C antigens was lost due to the development of chronic myelogenous leukemia (CML). For this patient, this represented more than a blood bank curiosity but was of critical importance in determining further treatment of the leukemia.
The mechanisms behind changes in RBC antigens due to malignancy are reviewed for a number of antigens, antigen systems, and antigen collections. Previous case reports of RBC antigen changes due to malignancy are summarized.