Platelet alloimmunization after long‐term red cell transfusion in transfusion‐dependent thalassemia patients

Lo, Su Shun; Chang, Jeng‐Shian; Lin, Susannah Whay-Sue; Lin, Dong‐Tsamn

doi:10.1111/j.1537-2995.2005.04246.x

Cited by 23 publications

(18 citation statements)

References 24 publications

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“…Patients who undergo periodic HLA antibody screening may demonstrate a decrease in PRA or a loss of HLA antibody as the time from the immunologic challenge lengthens [20,53]. Thus, it is important for clinicians to recognize that multiply transfused patients with a negative HLA antibody screen may still be at risk for subsequent adverse sequelae of HLA alloimmunization.…”

Section: Discussionmentioning

confidence: 99%

HLA alloimmunization is associated with RBC antibodies in multiply transfused patients with sickle cell disease

McPherson

Anderson

Bsn

et al. 2009

Pediatric Blood & Cancer

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Background Alloimmunization to minor red blood cell (RBC) antigens occurs commonly in sickle cell disease (SCD). Patients with alloimmunization demonstrate increased risk for new alloantibody formation with subsequent transfusion. Alloimmunization to human leukocyte antigens (HLA) can occur with RBC transfusion and may result in graft rejection during stem cell or organ transplantation. The prevalence and risk factors for HLA alloimmunization in multiply transfused pediatric SCD patients are unknown. Procedure A cross-sectional study of HLA alloimmunization in SCD patients aged 3–21 years with a history of ≥3 RBC transfusions was performed to test the hypothesis that HLA alloimmunization is associated with RBC alloimmunization. Antibodies to class I and class II HLA were measured by Flow Panel Reactive Antibody (FlowPRA®). Results Seventy-three SCD patients (30 with RBC antibodies) were tested. HLA antibodies were detected in 25/73 (34%) patients; class I HLA antibodies occurred in 24/73 (33%) and class II HLA antibodies occurred in 3 (4%). Among patients with RBC antibodies, 16/30 (53%) had HLA antibodies, while 9/43 (21%) patients without RBC antibodies had HLA antibodies (OR 4.32 [1.6–12.1]). In a multivariate analysis, antibodies to RBC antigens were an independent predictor of HLA alloimmunization (P =0.041). The association of RBC and HLA immunization was strongest among patients with no history of chronic transfusion therapy. Conclusions This analysis is the first description of HLA alloimmunization in pediatric SCD patients who receive primarily leukoreduced RBC transfusions and demonstrates that HLA alloimmunization tendency is associated with antibodies to RBC antigens.

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Section: Discussionmentioning

confidence: 99%

HLA alloimmunization is associated with RBC antibodies in multiply transfused patients with sickle cell disease

McPherson

Anderson

Bsn

et al. 2009

Pediatric Blood & Cancer

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“…It follows that children with thalassemia who require lifelong transfusions will also produce PRA. Recently, Lo and colleagues [11] analyzed 60 thalassemic patients who had received red blood cell transfusions and found HLA antibodies and platelet-specific antibodies in these patients. In our research, we examined the sera of 20 children with β-thalassemia major; 7 of them were PRA positive, and the positive intention ranged from 30 to 75%.…”

Section: Discussionmentioning

confidence: 98%

PANEL REACTIVE ANTIBODY IN THALASSEMIC SERUM INHIBITS PROLIFERATION AND DIFFERENTIATION OF CORD BLOOD CD34⁺CELLS IN VITRO

Fang

Yang

et al. 2009

Pediatric Hematology and Oncology

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Thalassemic children are at a high risk of graft rejection in cord blood transplantation. To investigate this possible mechanism, the authors evaluated the effect of panel reactive antibody on the growth of CD34(+) cells in vitro. On semisolid medium, CD34(+) cells derived from cord blood were incubated with thalassemic serum, and colony-forming units were counted after 10 days of culture. After incubation with serum-specific panel reactive antibody, profound decreases were found in the numbers of CFU-GM, CFU-GEMM and BFU-E compared with controls. The results indicated that serum-specific panel reactive antibody might have an apparent inhibition effect on proliferation and differentiation of cord blood CD34(+) cells.

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“…Repeated blood transfusions may be associated with some complications such as iron overload, platelet and RBC alloimmunization. [3][4][5] Repetition of transfusions exposes patients to various RBC antigens which provoke the patient's immune system to produce anti-erythrocyte antibodies (alloantibody and/or autoantibody). 6 Erythrocyte autoantibodies appear less frequently, but they can result in clinical hemolysis and in difficulty in cross-matching blood.…”

Section: Introductionmentioning

confidence: 99%

Red cell alloimmunization in multitransfused chronic renal patients on haemodialysis in a tertiary care centre of Jammu region

et al. 2018

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Background: There is a high incidence of alloimunization in many patients with diseases that require repetitive blood transfusions. One such group is chronic renal failure patients as majority of them have severe anemia due to deficiency of erythropoietin. As many such patients are unable to afford erythropoietin, they are treated with blood transfusions. This study was thus undertaken to study alloimunization in such patients at our center.Methods: A total of 96 patients found eligible were enrolled in this cross-sectional study that was carried out from June 2016 to august 2016. After detailed history, antibody screening was done by using Immucor Panoscreen three vial set and if screening came out to be positive antibody identification was then done by using Immucor Panocell-10.Results: 96 patients including 76 male and 20 female patients recieved a total of 912 transfusions. Alloantibodies were detected in a total of 12 patients (12.5%). Of these 12 patients 8 patients had a single antibody whereas 4 patients developed two antibodies. The antibodies developed at a rate of 1.8% per transfusion (16/912). On alloantibody type identification, the most common type found was anti E (4/16) followed by both anti D and anti C in 3 patients each.Conclusions: Alloimmunization to minor erythrocyte antigens occurs in many patients of chronic renal failure. This results in frequent pre-and post-transfusion complications. Inclusion of antibody screening test in routine pretransfusion testing protocol for the patients who are at higher risk of alloimmunization and require long-term transfusion dependence is desirable.

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Platelet alloimmunization after long‐term red cell transfusion in transfusion‐dependent thalassemia patients

Cited by 23 publications

References 24 publications

HLA alloimmunization is associated with RBC antibodies in multiply transfused patients with sickle cell disease

HLA alloimmunization is associated with RBC antibodies in multiply transfused patients with sickle cell disease

PANEL REACTIVE ANTIBODY IN THALASSEMIC SERUM INHIBITS PROLIFERATION AND DIFFERENTIATION OF CORD BLOOD CD34⁺CELLS IN VITRO

Red cell alloimmunization in multitransfused chronic renal patients on haemodialysis in a tertiary care centre of Jammu region

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Platelet alloimmunization after long‐term red cell transfusion in transfusion‐dependent thalassemia patients

Cited by 23 publications

References 24 publications

HLA alloimmunization is associated with RBC antibodies in multiply transfused patients with sickle cell disease

HLA alloimmunization is associated with RBC antibodies in multiply transfused patients with sickle cell disease

PANEL REACTIVE ANTIBODY IN THALASSEMIC SERUM INHIBITS PROLIFERATION AND DIFFERENTIATION OF CORD BLOOD CD34+CELLS IN VITRO

Red cell alloimmunization in multitransfused chronic renal patients on haemodialysis in a tertiary care centre of Jammu region

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PANEL REACTIVE ANTIBODY IN THALASSEMIC SERUM INHIBITS PROLIFERATION AND DIFFERENTIATION OF CORD BLOOD CD34⁺CELLS IN VITRO