Red cell membrane alteration associated with "marrow stress".

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Abstract
Agglutirability of red cells by the blood group antibody, anti-i, was induced in normal adults by subjecting their bone marrow to the stress of repeated phlebotomy. This reactivity with anti-i, normally confined to the red cells of infants, was also noted in some, but not all, patients with anemia. There was no apparent correlation of i reactivity with red cell production rate of reticulocyte level, but it could be correlated with rapid intra-marrow transit time of developing red cells, as measured by radioiron kinetic studies. These findings suggest the possibility that very early red cell precursors normally produce i antigen which is lost during intra-marrow maturation, and that persistence of i occurs when release of red cells from the marrow is premature.