A study of red blood cell alloimmunization and autoimmunization among 200 multitransfused Egyptian β thalassemia patients

El‐Beshlawy, Amal; Salama, A; El-Masry, Mohamed Roshdy; Husseiny, Noha M. El; Abdel-Hameed, A.

doi:10.1038/s41598-020-78333-y

Cited by 21 publications

(28 citation statements)

References 56 publications

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“…Similarly, in this study, the M and N antigens were observed with higher frequencies of 82.4% and 62.7% respectively in beta-thalassemia patients. However, in comparison, El-Beshlawy et al from Egypt reported much lower frequencies of M and N antigens at 8.14% and 1.16% respectively [30]. Our study results have variations among blood group antigens and different hematological diseases especially in beta-thalassemia due to genetic differences among different ethnic groups.…”

Section: Discussioncontrasting

confidence: 59%

Frequency of Extended Red Cell Antigen Phenotype Among Patients of Hematological Diseases: A Single Center Study

Tariq¹,

Ahmed²,

Ashfaq³

et al. 2022

Cureus

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BackgroundAlloimmunization of erythrocytes is a major problem in patients with hematological diseases that require frequent blood transfusions. Matching of extended red cell antigens of Kell, MNS, Kidd, and Duffy can decrease the risk of alloimmunization. Hence, in this study, the frequencies of the extended red cell phenotypes were explored. ObjectiveTo find out the frequency of extended red blood cell antigen phenotypes among patients with hematological diseases. MethodsThis cross-sectional research study was performed on 488 patients diagnosed with hematological diseases who required blood transfusion at the National Institute of Blood Disease and Bone Marrow Transplantation Karachi for a period of 1.42 years from November 2019 to March 2021. The blood of patients was analyzed for antigen phenotypes of different blood group systems including Kell, MNS, Kidd, and Duffy. The data obtained were interpreted. ResultsAmong the 488 patients, 284 (58.20%) patients were male, and 204 (41.80%) patients were female with a mean age of 8.1 years. Beta thalassemia was the most common hematological disease reported in 354 (72.5%) of the patients. The most common blood group was O positive reported in 182 (37.3%) of the patients followed by B positive blood group in 124 (25.4%). The frequencies of extended red cell antigen phenotypes in the patients were K antigen 14 (2.9%), Kp a antigen 26 (5.3%), Kp b antigen 424 (86.9%), Fy a antigen 360 (73.8%), Fy b antigen 260 (53.3%), Jk a antigen 294 (60.2%), Jk b antigen 326 (66.8%), M antigen 410 (84.0%) and N antigen 306 (62.7%). ConclusionBeta thalassemia was the most common hematological disease followed by iron deficiency anemia, aplastic anemia, and acute leukemia. Patients with hematological diseases had a higher prevalence of Kp b antigen followed by M, Fy a , Jk b , N, Jk a , Fy b , Kp a, and K antigen. O positive was the most frequent blood group followed by B positive, A positive and AB positive blood group.

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Section: Discussioncontrasting

confidence: 59%

Frequency of Extended Red Cell Antigen Phenotype Among Patients of Hematological Diseases: A Single Center Study

Tariq¹,

Ahmed²,

Ashfaq³

et al. 2022

Cureus

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“…Overall, autoAb frequency ranges from 1% to 28.2% in β-thalassemia [ 17 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ], from 0.8% to 42% in SCD [ 27 , 28 , 29 , 30 ], and reaches 61% in HS (likely due to more sensitive technique) [ 11 ]. Few data are available about the Ab type, with warm antibodies (IgG+) being reported in half of the DAT-positive cases, IgG+ complement (C)—in approximately one third of cases, and C+—in the remaining cases.…”

Section: Resultsmentioning

confidence: 99%

Autoimmune Hemolytic Anemia as a Complication of Congenital Anemias. A Case Series and Review of the Literature

Motta

Giannotta

Ferraresi

et al. 2021

JCM

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Congenital anemias may be complicated by immune-mediated hemolytic crisis. Alloantibodies are usually seen in chronically transfused patients, and autoantibodies have also been described, although they are rarely associated with overt autoimmune hemolytic anemia (AIHA), a serious and potentially life-threatening complication. Given the lack of data on the AIHA diagnosis and management in congenital anemias, we retrospectively evaluated all clinically relevant AIHA cases occurring at a referral center for AIHA, hemoglobinopathies, and chronic hemolytic anemias, focusing on clinical management and outcome. In our cohort, AIHA had a prevalence of 1% (14/1410 patients). The majority were warm AIHA. Possible triggers were recent transfusion, infection, pregnancy, and surgery. All the patients received steroid therapy as the first line, and about 25% required further treatment, including rituximab, azathioprine, intravenous immunoglobulins, and cyclophosphamide. Transfusion support was required in 57% of the patients with non-transfusion-dependent anemia, and recombinant human erythropoietin was safely administered in one third of the patients. AIHA in congenital anemias may be challenging both from a diagnostic and a therapeutic point of view. A proper evaluation of hemolytic markers, bone marrow compensation, and assessment of the direct antiglobulin test is mandatory.

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“…Thalassemia is another hemoglobinopathy that requires chronic transfusion therapy. Alloantibodies occur in 5-30% of thalassemia patients, and are more common after splenectomy, long duration of treatment and frequent transfusion [61][62][63][64]. The dominant antibodies are against the Rh and Kell groups, each comprises 20-30% of the antibodies [64].…”

Section: Non-abo Blood Groups Incompatibilitymentioning

confidence: 99%

“…Alloantibodies occur in 5-30% of thalassemia patients, and are more common after splenectomy, long duration of treatment and frequent transfusion [61][62][63][64]. The dominant antibodies are against the Rh and Kell groups, each comprises 20-30% of the antibodies [64]. When prophylactically transfusing Rh (D, C, E) and K antigen matched RBC units, alloantibodies were still detected in 32.5% of patients, with an alloimmunization rate of 0.26 antibodies/100 units, and 72.5% of antibodies were directed against Rh [63].…”

Section: Non-abo Blood Groups Incompatibilitymentioning

confidence: 99%

“… 60-63 The dominant antibodies are against the Rh and K groups, each comprising 20% to 30% of the antibodies. 63 When prophylactically transfusing Rh (D, C, and E) antigen– and K antigen–matched RBC units, alloantibodies were still detected in 32.5% of patients, with an alloimmunization rate of 0.26 antibodies per 100 units, and 72.5% of antibodies were directed against Rh. 62 There are limited data on how non-ABO alloantibodies affect HSCT outcomes in patients with thalassemia.…”

Section: Non-abo Blood Group Incompatibilitymentioning

confidence: 99%

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Post–hematopoietic stem cell transplantation immune-mediated anemia: a literature review and novel therapeutics

et al. 2022

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Anemia following allogeneic hematopoietic stem cell transplantation (HCT) can be immune- or non-immune mediated. Auto- or alloimmunity due to blood groups incompatibility remain an important cause if post-HCT immune-mediated anemia. ABO incompatibility is commonly encountered in HCT and may lead to serious clinical complications including acute hemolysis, pure red cell aplasia, and passenger lymphocyte syndrome. It remains controversial whether ABO incompatibility may affect HCT outcomes, such as relapse, non-relapse mortality, graft-versus-host disease and survival. Non-ABO incompatibility is less frequently encounterd but can have similar complications to ABO incompatibility, causing adverse clinical outcomes. It is crucial to identify the driving etiology of post-HCT anemia in order to prevent and treat this condition. This requires a comprehensive understanding of the mechanism of anemia in blood group incompatible HCT, and the temporal association between HCT and anemia. In this review, we summarized the literature on post-HCT immune-mediated anemia with a focus on ABO and non-ABO blood group incompatibility, described the underlying mechanism of anemia, and outlined preventive and treatment approaches.

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A study of red blood cell alloimmunization and autoimmunization among 200 multitransfused Egyptian β thalassemia patients

Cited by 21 publications

References 56 publications

Frequency of Extended Red Cell Antigen Phenotype Among Patients of Hematological Diseases: A Single Center Study

Frequency of Extended Red Cell Antigen Phenotype Among Patients of Hematological Diseases: A Single Center Study

Autoimmune Hemolytic Anemia as a Complication of Congenital Anemias. A Case Series and Review of the Literature

Post–hematopoietic stem cell transplantation immune-mediated anemia: a literature review and novel therapeutics

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