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 Table of Contents  
Year : 2022  |  Volume : 7  |  Issue : 1  |  Page : 105

Prevalence of bombay phenotype (Oh) among Bangladeshi population

1 Department of Transfusion Medicine, Evercare Hospital Dhaka, Dhaka, Bangladesh
2 Department of Transfusion Medicine, Asgar Ali Hospital Dhaka, Dhaka, Bangladesh
3 Department of Transfusion Medicine and Clinical Hematology, BIRDEM General Hospital and Ibrahim Medical College, Dhaka, Bangladesh
4 Department of Hematology and Stem Cell Transplant, Evercare Hospital Dhaka, Dhaka, Bangladesh

Date of Submission21-Feb-2022
Date of Decision21-Feb-2022
Date of Acceptance21-Feb-2022
Date of Web Publication29-Apr-2022

Correspondence Address:
Dr. Tamanna Afroz
Department of Transfusion Medicine, Evercare Hospital Dhaka, Dhaka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/gjtm.gjtm_14_22

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How to cite this article:
Afroz T, Naznin B, Parvin F, Saleh AJ. Prevalence of bombay phenotype (Oh) among Bangladeshi population. Glob J Transfus Med 2022;7:105

How to cite this URL:
Afroz T, Naznin B, Parvin F, Saleh AJ. Prevalence of bombay phenotype (Oh) among Bangladeshi population. Glob J Transfus Med [serial online] 2022 [cited 2022 Sep 25];7:105. Available from: https://www.gjtmonline.com/text.asp?2022/7/1/105/344330


The rare Bombay phenotype (Oh) was discovered almost 70 years back by Dr. Y. M. Bhende. The genetic inheritance is said to be recessive with the presence of double dose of h gene. The molecular basis of these phenotypes is mutation in the FUT1 gene, which results in the formation of complete H-deficient phenotype.[1] Bombay phenotype has no “A” or “B” or “H” antigens on red cells or secretions. Their serum contains anti-A, anti-B, and anti-H. The naturally occurring (IgM) anti-H can activate the complement cascade and cause intravascular hemolysis.

Among Caucasians, the incidence is 1 in 250,000, and in Europe, the incidence is 1 per 1,000,000 individuals. It has the highest prevalence in India with respect to the world and found 1 in every 10,000 individuals.[2] Literature review revealed Bombay phenotype is more prevalent in closed communities with a high rate of consanguineous marriage. It is very likely that other family members could carry the same phenotype. Thus, proper screening among such families needs to be done. During blood grouping, reaction with O control cell in reverse grouping gives a clue to Bombay phenotype. Confirmation can be done by H lectin (Ulex europaeus) having anti-H–like activity.

A total 31,076 samples were received for ABO and RhD blood grouping in two different tertiary care centers of Bangladesh in 2021. Of these, two cases of Bombay phenotype were suspected and confirmed using anti-H lectin. The incidence was 0.006%. Both cases were RhD positive. Consanguinity was absent in both cases. Fortunately, none of them needed blood transfusion.

In Bangladesh, the first documented Bombay phenotype was found in the Miah family in 1990.[3] Till 2011, only nine people with Bombay phenotype had been formally reported.[4] The phenotype can be easily misinterpreted as blood group “O” if blood grouping is not thoroughly carried out. At present, in our country, there is routine practice of doing only “forward or cell type grouping” using finger-prick method in vast majority cases. This results in incorrect blood group typing failure to pick up Bombay (Oh) group. Catastrophic hemolytic transfusion reactions are a serious threat in such cases. Hence, mandatory forward and reverse grouping along with “O” control should be done every time. Bombay phenotype individuals can donate red blood cells to any ABO blood group patient if rhesus is compatible. They can receive fresh frozen plasma and cryoprecipitate from any group but can receive red cells only either from autologous or from another Bombay individual. Considering the rarity, any person with this phenotype who needs an urgent blood transfusion will probably be unable to manage, as no blood bank would have any in stock. Therefore, this is high time to ensure a rare blood donor registry at least in tertiary care centers in Bangladesh to make a robust network for blood distribution when needed.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Das PK, Nair SC, Harris VK, Rose D, Mammen JJ, Bose YN, et al. Distribution of ABO and Rh-D blood groups among blood donors in a tertiary care centre in South India. Trop Doct 2001;31:47-8.  Back to cited text no. 1
Oriol R, Candelier JJ, Mollicone R. Molecular genetics of H. Vox Sang 2000;78 Suppl 2:105-8.  Back to cited text no. 2
Rahman M, Abdullah AZ, Husain M, Hague KM, Hossain MM. A Bangladeshi family with three sisters 'Bombay' or Oh phenotype. Bangladesh Med Res Counc Bull 1990;16:75-85.  Back to cited text no. 3
Dipta TF, Hossain KN, Khatun A. Bombay phenotype: Report of 2 cases. J Bangladesh Coll Physicians Surg 2011;29:241-3.  Back to cited text no. 4


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