Prospective RBC phenotype matching in a stroke‐prevention trial in sickle cell anemia: a multicenter transfusion trial

Vichinsky, Elliott; Luban, Naomi L.C.; Wright, Elizabeth C.; Olivieri, Nancy F.; Driscoll, Catherine; Pegelow, Charles H.; Adams, Robert J.

doi:10.1046/j.1537-2995.2001.41091086.x

Cited by 308 publications

(260 citation statements)

References 41 publications

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“…However, the immunological processes that occur during various SCD complications make it difficult to ascertain why ACS and VOC may be associated with significantly higher alloimmunization rates than other acute SCD-related complications. Consistent with previous reports (Rosse et al, 1990;Tahhan et al, 1994;Vichinsky et al, 2001;Aygun et al, 2002;Castro et al, 2002;Sakhalkar et al, 2005;Lasalle-Williams et al, 2011), we also observed that unmatched (CEK) transfusion was associated with an increased risk of alloimmunization in both univariate and multivariate analysis. In fact we observed the same alloimmunization rate (2Á6%) in CEK matched transfusions as reported by Sakhalkar et al (2005), and detected no antibodies following level 3 or higher matching despite the fact that our transfusions were strictly administered to a SCD population defined as 'responders.'…”

Section: Discussionsupporting

confidence: 92%

Red blood cell alloimmunization is influenced by recipient inflammatory state at time of transfusion in patients with sickle cell disease

et al. 2014

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SummarySickle cell disease (SCD) patients are at increased risk of red blood cell (RBC) alloimmunization. Recipient inflammatory state at time of transfusion has been shown to regulate alloimmunization in murine models, but evidence is lacking in SCD patients. We retrospectively studied a cohort of alloimmunized SCD patients to determine the influence of pro-inflammatory SCD-related complications at time of transfusion on alloimmunization. For each transfusion, the presence of pro-inflammatory state, degree of RBC antigen matching, unit age, storage solution and alloantibody detection date were ascertained. Transfusion-associated pro-inflammatory events were compared between transfusions resulting and not resulting in new alloantibodies. Univariate analysis and multivariate logistic regression were performed. Fifty-two patients received 3166 pre-storage leuco-reduced transfusions of which 128 resulted in alloantibodies. Transfusions during inflammatory events were associated with increased alloantibody risk on univariate and multivariate analysis; acute chest syndrome and vaso-occlusive crisis showed strongest associations with alloimmunization. Increased antigen matching demonstrated a protective effect on alloimmunization (univariate and multivariate analysis). Although an association was seen between citrate-phosphate-dextrose (adenine) stored units and alloimmunization on univariate analysis, no effect was found on multivariate analysis. Identifying recipient pro-inflammatory states at time of transfusion that promote alloimmunization can impact RBC unit selection decisions for SCD patients at risk for alloimmunization.

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Section: Discussionsupporting

confidence: 92%

Red blood cell alloimmunization is influenced by recipient inflammatory state at time of transfusion in patients with sickle cell disease

et al. 2014

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“…Attempting to identify blood lacking the antigen to which an antibody is formed can be difficult [6,7]. Matching red blood cell components between donors and recipients for more than ABO and Rh blood groups may decrease the rate of alloimmunization and the number of hemolytic reactions among recipients [8]. Blood donors from a similar ethnic group may maximize the yield of blood donors that are phenotypically compatible.…”

Section: Introductionmentioning

confidence: 99%

Barriers and motivators to blood and cord blood donations in young African-American women

Grossman

Watkins

Fleming³

et al. 2005

Am. J. Hematol.

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The primary aim of this study was to assess potential barriers and motivators to blood and cord blood donation among African-American women. A telephone survey of AfricanAmerican women, ages 18-30 years, in the St. Louis metropolitan area was performed. The survey was administered by trained telemarketing personnel using a ComputerAssisted Direct Interview (CADI) system. One hundred sixty-two women were surveyed. Common barriers to blood donation were inconvenience of donor sites (19%), fear of needles (16%), and too much time required to donate (15%). Potential motivators were increasing awareness of need for blood (43%), increasing the number of convenient donor locations (19%), and encouragement by spiritual leaders to have blood drives at their church (17%). Lack of awareness was the only identified barrier to cord blood donation. Most women surveyed (88%) indicated that they definitely or probably would donate cord blood. Strategies to increase the proportion of African-American blood and cord blood donations may include educating potential donors about the process and benefits of donation to particular patient populations and engaging church leadership in supporting blood and cord blood donations. Am.

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“…The exact number of cumulative transfusions from birth to first antibody formation is often not reported and in many studies it is unclear if the transfusion history has been fully traced, including transfusions outside the reporting centers [9,10,12,[14][15][16]28]. Yet, the exposure to foreign RBC antigens is a prerequisite for alloimmunization and higher incidences of alloimmunization have been observed in patients with a higher number of transfusions [5,7,8,27,29].…”

mentioning

confidence: 99%

Early occurrence of red blood cell alloimmunization in patients with sickle cell disease

et al. 2016

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Red blood cell (RBC) alloimmunization is a major complication of transfusion therapy in sickle cell disease (SCD). Identification of high-risk patients is hampered by lack of studies that take the cumulative transfusion exposure into account. In this retrospective cohort study among previously non-transfused SCD patients in the Netherlands, we aimed to elucidate the association between the cumulative transfusion exposure, first alloimmunization and independent risk factors. A total of 245 patients received 11 952 RBC units. Alloimmunization occurred in 43 patients (18%), half of them formed their first alloantibody before the 8th unit. In patients with exposure to non-extended matched transfusions (ABO and RhD) the cumulative alloimmunization risk increased up to 35% after 60 transfused units. This was significantly higher compared to a general transfused population (HR 6.6, CI 4.2-10.6). Receiving the first transfusion after the age of 5 was an independent risk factor for alloimmunization (HR 2.3, CI 1.0-5.1). Incidental, episodic transfusions in comparison to chronic scheme transfusions (HR 2.3, CI 0.9-6.0), and exposure to non-extended matched units in comparison to extended matching (HR 2.0, CI 0.9-4.6) seemed to confer a higher alloimmunization risk. The majority of first alloantibodies are formed after minor transfusion exposure, substantiating suggestions of a responder phenotype in SCD and stressing the need for risk factor identification. In this study, older age at first transfusion, episodic transfusions and non-extended matched transfusions appeared to be risk factors for alloimmunization.

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Prospective RBC phenotype matching in a stroke‐prevention trial in sickle cell anemia: a multicenter transfusion trial

Cited by 308 publications

References 41 publications

Red blood cell alloimmunization is influenced by recipient inflammatory state at time of transfusion in patients with sickle cell disease

Red blood cell alloimmunization is influenced by recipient inflammatory state at time of transfusion in patients with sickle cell disease

Barriers and motivators to blood and cord blood donations in young African-American women

Early occurrence of red blood cell alloimmunization in patients with sickle cell disease

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