Alloimmunization against Rh and Kell blood groups antigens is the main obstacle for blood transfusion in transfusion dependent thalassemia patients in Iran

Dorgalaleh, Akbar; Gholami, Mohammad Saeed; Shokuhiyan, Mohammad; Valikhani, Mohsen; Moghaddam, Esmaei Saneei; Naderi, Majid

doi:10.5348/ijcri-201708-ed-10008

Cited by 5 publications

(3 citation statements)

References 14 publications

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“…[ 56 57 58 ] Antibodies are most commonly developed against K antigen in Kell blood system, while anti-D, -E, and -C antibodies are most frequently found in Rh blood system. [ 59 60 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 68 ] We report 1% autoantibody prevalence among 3787 patients, which is close to prevalence reported in other countries. [ 59 ] No association was found between autoantibody incidence and age, quality score, splenectomy proportion, male/female proportion, and location of subjects of studies with meta-regression analysis. The number of transfused blood units increased with older age; thus, it could be considered as an RBC alloimmunization risk factor.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence and specificity of red blood cell alloantibodies and autoantibodies in transfused Iranian β-thalassemia patients: A systematic review and meta-analysis

Alipour¹,

Rostamian²,

Javandoost³

et al. 2022

Asian J Transfus Sci

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BACKGROUND: Repeated allogeneic blood transfusions in thalassemia major patients stimulate the patient's immune system to generate antibodies against foreign erythrocyte antigens. This study was carried out to systematically review the findings of available studies about the prevalence of alloantibodies and autoantibodies, as well as the type of causative antigens among transfusion-dependent thalassemia patients in Iran. METHODS: Electronic search was conducted on Medline, PubMed, Cochrane, EMBASE, ScienceDirect, and Persians databases. All relevant articles published from January 1990 to July 2018 were included. Abstracts of conference booklets which that been published in the last 5 years were also included in the meta-analysis. The search language was restricted to English and Persian. The quality of studies was evaluated according to a checklist developed by authors, and Cochrane Risk of Bias Assessment Tool was used to evaluate the risk of bias. RESULTS: Twenty-three relevant articles met all the inclusion criteria. The prevalence of alloimmunization was 13%. Our study showed that anti-D (25%) and anti-K (25%) were most prevalent among Iranian β-thalassemia patients. Data analysis shows the autoantibody prevalence to be 1% among 3787 patients. Meta-regression revealed that the prevalence of alloantibodies increases with each year as the average age of the study population increases. CONCLUSION: The prevalence of red blood cell (RBC) alloantibodies in transfused Iranian β-thalassemia patients was high. Appropriate preventive strategies such as RBC phenotyping for patients before beginning transfusion and using extended RBC donor–recipient matching, specifically for Rh and Kell system, could be implemented to avoid complications in thalassemia patients.

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“…[ 56 57 58 ] Antibodies are most commonly developed against K antigen in Kell blood system, while anti-D, -E, and -C antibodies are most frequently found in Rh blood system. [ 59 60 ]…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prevalence and specificity of red blood cell alloantibodies and autoantibodies in transfused Iranian β-thalassemia patients: A systematic review and meta-analysis

Alipour¹,

Rostamian²,

Javandoost³

et al. 2022

Asian J Transfus Sci

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“…Also, there are different races in Iran (Arab, Lor, Turk, Fars, etc. ), which may lead to a higher rate of antibody production because blood group frequencies may differ between races (Dorgalaleh et al, 2017 ; Karimi et al, 2007 ). Thus, the prevention of initial or additional alloantibody formation by an antigen‐matched transfusion is critical for multi‐transfused patients in Iran.…”

Section: Introductionmentioning

confidence: 99%

Blood group genotyping in alloimmunized multi‐transfused thalassemia patients from Iran

Sarihi

Oodi

tehrani

et al. 2021

Molec Gen & Gen Med

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Objectives Serological methods may not be reliable for RBC antigen typing, especially in multi‐transfused patients. The blood group systems provoking the most severe transfusion reactions are mainly Rh, Kell, Kidd, and Duffy. We intended to determine the genotype of these blood group system antigens among Iranian alloimmunized thalassemia patients using molecular methods and compare the results with serological phenotyping. Methods Two hundred patients participated in this study. Blood group phenotype and genotype were determined using the serological method and PCR‐SSP, respectively. The genotypes of patients with incompatibility between phenotype and genotype were re‐evaluated by RFLP‐PCR and confirmed by DNA sequencing. Results Discrepancies between phenotype and genotype results were found in 132 alleles and 83 (41.5%) patients; however, there was complete accordance between the three genotyping methods. Most discrepancies were detected in Rh and Duffy systems with 47 and 45 cases, respectively, and the main discrepancy was in the FY*B/FY*B allele when serologically showed Fy(a+b+). All 39 undetermined phenotypes, due to mixed‐field reactions, were resolved by molecular genotyping. Conclusion Molecular genotyping is more reliable compared with the serological method, especially in multi‐transfused patients. Therefore, the addition of blood group genotyping to serological assays can lead to an antigen‐matched transfusion in these patients.

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Genomic analyses of KEL alleles in alloimmunized thalassemia patients from Iran

Sarihi

Amirizadeh

Oodi

2020

Transfusion and Apheresis Science

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Alloimmunization against Rh and Kell blood groups antigens is the main obstacle for blood transfusion in transfusion dependent thalassemia patients in Iran

Cited by 5 publications

References 14 publications

Prevalence and specificity of red blood cell alloantibodies and autoantibodies in transfused Iranian β-thalassemia patients: A systematic review and meta-analysis

Prevalence and specificity of red blood cell alloantibodies and autoantibodies in transfused Iranian β-thalassemia patients: A systematic review and meta-analysis

Blood group genotyping in alloimmunized multi‐transfused thalassemia patients from Iran

Genomic analyses of KEL alleles in alloimmunized thalassemia patients from Iran

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