RBC alloimmunization and autoimmunization among transfusion‐dependent Arab thalassemia patients

Ameen, Reem; Alshemmari, Salem; Al-Humood, Salah; Chowdhury, Rafiqul I.; Al-Eyaadi, Ohood; Al-Bashir, Abdulaziz

doi:10.1046/j.1537-2995.2003.00549.x

Cited by 132 publications

(173 citation statements)

References 32 publications

(40 reference statements)

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“…As seen the reported alloimmunisation rates in thalassemics from other parts of India vary from 3.79-9.48 % [8,13,19]. In our study frequency of alloimmunization and autoimmunization was 8.6 and 1.8 % respectively which is similar to that reported from other centers in our country.…”

Section: Discussionsupporting

confidence: 88%

“…Their data was similar to an Asian study which reported autoantibodies in 25 % of their thalassaemia patients [5]. Also a study from Kuwait observed autoantibodies in 11 % of their patients [19]. However, a study in Iran found autoantibodies in 1.4 % of their thalassemia patients [9].…”

Section: Discussionsupporting

confidence: 84%

“…These alloimmunization rates can be termed as moderate. In contrast, low immunization rates are reported in blood donors (0.8 %) or other hospital base patients (1-2 %) [24,25]; or high alloimmunization rates of more than 20 % reported in thalassemics from China [7], USA and UK [6], USA [5], Taiwan [14], Arab [19] and in Sickle Cell Disease (SCD) patients [10]. The alloimmunization rates in other frequently transfused patients from our country have also been reported to be moderate i.e.…”

Section: Discussionmentioning

confidence: 99%

“…The relative homogeneity of donor and recipient populations in Greece and Italy has been shown to contribute to lower alloimmunization rates for transfused patients with thalassaemia [11,12] compared to more heterogeneous populations in other countries, such as Kuwait [19] and Taiwan [14]. One study from USA reported an alloimmunization rate of 20.8 % in Asians patients with thalassaemia where only 5 % of local blood donors were Asian [5].…”

Section: Rbc Antigenic Differences Between Blood Donor and Recipientmentioning

confidence: 99%

“…In our study alloantibodies formed 3-21 years after transfusion or after transfusion of median 136 units of red cells. Although gender has been identified a risk factor for alloimmunization in the general population [33], studies of thalassaemia have not found higher rates in women [6,19,34]. Splenectomy, which is typically performed in thalassaemia patients to alleviate hypersplenism or stabilize transfusion requirements, has been reported to be a significant risk factor for alloimmunization [5,6,34].…”

Section: Other Factorsmentioning

confidence: 99%

See 4 more Smart Citations

Red Blood Cell Antibodies in Thalassemia Patients in Northern India: Risk Factors and Literature Review

Elhence

Solanki

Verma

2014

Indian J Hematol Blood Transfus

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Study of the factors responsible for red cell alloimmunization can help in adopting appropriate strategy to minimize alloimmunization. However data for thalassemia patients from our region is limited. Therefore, a study was conducted to find out the frequency and the factors associated with red cell allo and autoimmunization in thalassemia patients at our center so as to enable us to take appropriate action to reduce alloimmunization. Clinical, demographic, allo and autoantibody and transfusion records of 280 thalassemia patients at our hospital were studied. Patients with and without alloantibodies were compared to find significant differences for age, gender, race, age at start of regular transfusions and splenectomy. Red cell antigen frequencies in thalassemia patients and published antigen frequencies in blood donors from the same center were compared to look antigen differences as a risk factor for alloimmunization. Twenty four thalassemia patients (8.6 %) developed 28 clinically significant alloantibodies. 18 (65 %) of the alloantibodies were of Rh system. The three most common antibodies detected was anti E (11, 39.3 %) followed by anti K (6, 21.4 %) and anti c (10.8 %). Five (1.8 %) of the 280 patients developed autoantibodies. Patient age was found to be significantly higher in alloimmunized patients than in non alloimmunized patients. Red cell antigen frequencies between blood donor and recipient populations were found to be homogenous for most of the relevant RBC antigens. The frequency of red cell alloimmunization in thalassemia patients from our center is moderate. In this setting of red cell phenotype concordant donor-recipient population requirement of extended phenotype matched transfusions may not be cost effective.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Rbc Antigenic Differences Between Blood Donor and Recipientmentioning

confidence: 99%

Section: Other Factorsmentioning

confidence: 99%

See 3 more Smart Citations

Red Blood Cell Antibodies in Thalassemia Patients in Northern India: Risk Factors and Literature Review

Elhence

Solanki

Verma

2014

Indian J Hematol Blood Transfus

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Hazards of Transfusion

Luban¹,

Wong²

2006

Pediatric Hematology

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Prevention of red cell alloimmunization by CD25 regulatory T cells in mouse models

Heck

Yazdanbakhsh

2007

American J Hematol

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Transfusion therapy is currently an effective therapeutic intervention in a number of diseases, including sickle cell disease. However, its use is complicated by a high incidence of red blood cell (RBC) alloimmunization in the transfusion recipients. The identification of T regulatory cells (Tregs) among the CD4 þ CD25 þ T cell subset as key regulators of peripheral tolerance in mice as well as humans has opened an exciting era in the prevention and treatment of autoimmune disease and for improving organ transplantation. However, their potential in inducing transfusion tolerance remains to be explored. We used red cells from mice transgenic for human glycophorin A blood group antigen as donor cells and transfused wild-type mice to induce alloantibodies, as an experimental system to study RBC alloimmunization. We found that depletion with anti-CD25 enhanced the alloantibody production, indicating that CD25 Tregs play an important role in regulation of alloantibody responses. More importantly, adoptive transfer of purified population of-cells from naïve mice prevented the induction of IgG and IgM alloantibody production in transfusion recipients, with a concomitant reduction in activated splenic B cells and macrophages. Similarly, adoptive transfer of purified populations of CD4 þ CD25 þ cells from naïve mice into naïve syngeneic recipients inhibited the anti-Ig response to rat RBCs in the recipients but transfer of control CD4 þ CD25 -cells did not. Altogether, our results demonstrate that Tregs participate in the control of transfusion-associated RBC alloantibody responses, opening up the possibility that Treg immunotherapy may be exploited for suppressing transfusion immunization events. Am. J. Hematol. 82:691-696, 2007.

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RBC alloimmunization and autoimmunization among transfusion‐dependent Arab thalassemia patients

Cited by 132 publications

References 32 publications

Red Blood Cell Antibodies in Thalassemia Patients in Northern India: Risk Factors and Literature Review

Red Blood Cell Antibodies in Thalassemia Patients in Northern India: Risk Factors and Literature Review

Hazards of Transfusion

Prevention of red cell alloimmunization by CD25 regulatory T cells in mouse models

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