Red Blood Cell Alloimmunization in Sickle Cell Disease Patients in Jeddah, Saudi Arabia: A Pilot Study.

Abstract

The treatment of patients with sickle cell disease frequently requires transfusion of red blood cells. Complications due to alloimmunization of red blood cells antigen remain a major risk as a post transfusion effect. The objective of this study is to determine the frequency of red cell alloimmunization in Jeddah, Saudi Arabia. A retrospective cross-section study of sickle cell disease patients at King Abdulaziz University Hospital between 2012 and 2013 was performed. Demographic characteristics and transfusion history was recorded. Blood samples were analyzed for alloimmunization using immunohematological technique. A total of 234 sickle cell patients were analyzed, of which 30 (12.8%) showed alloantibodies. A total of 43 alloantibodies were found out of which 28 belonged to Rh group, eight belonged to Kell while three belonged to MNS group. Demographic and transfusion characteristics were analyzed between alloimmunized and nonalloimmunized sickle cell disease patients. The rate of alloimmunization in Jeddah, Saudi Arabia was 12.8%. There was significant difference observed between alloantibodies detection between transfused patients compared to non-transfused patients. The consequences of red blood cell alloimmunization are highly significant and therefore immune hematological testing is highly recommended.

The value of transfusion of phenotyped blood units for thalassemia and sickle cell anemia patients at an academic center

“…12 Rh and Kell blood group antibodies are most commonly expressed in both thalassemic and sickle cell patients, with other RBC antibodies also clinically implicated from reports. 16 Two recent studies on sickle cell and thalassemia patients at KAUH showed a high rate of alloimmunization: 61 out of 349 (17.47%) and 27 out of 134 (20.15%), respectively. These rates were shown to be higher in our study, which is due to frequent transfusions of non-phenotypically matched blood units.…”

“…3 Another study in the western part of the same country, carried out in 2012-2013 at KAUH, screened 234 sickle cell patients for alloantibodies, discovering that 12.8% (30 patients) expressed alloantibodies. 16 In a similar report from Oman, 31.5% (42/133) of sickle cell patients expressed alloantibodies. 21 The alloimmunization rates in this group of patients were also shown to greatly vary (18%-76%) in many other countries, including the United States, the United Kingdom, Kuwait, and Brazil.…”

“…10 Numerous studies have reported a high frequency of alloimmunization in thalassemia patients: 30% (57/190) in Kuwait, 4.97% (8/161) in India, 5% (72/1435) in Italy, 26.25% (84/320) in Egypt, 22.06% (16/68) in Saudi Arabia, and 3.7% (44/1200) in Greece. 5,[10][11][12][13][14][15][16][17][18][19][20] A similar study of sickle cell anemia patients was conducted in eastern Saudi Arabia and reported expression of alloantibodies in 13.7% of patients (48/350). 3 Another study in the western part of the same country, carried out in 2012-2013 at KAUH, screened 234 sickle cell patients for alloantibodies, discovering that 12.8% (30 patients) expressed alloantibodies.…”

“…The frequency of alloimmunization depends on the homogeneity of the donor‐recipient population, the RBC phenotype coordinating process and the patient age at the start of transfusion . Numerous studies have reported a high frequency of alloimmunization in thalassemia patients: 30% (57/190) in Kuwait, 4.97% (8/161) in India, 5% (72/1435) in Italy, 26.25% (84/320) in Egypt, 22.06% (16/68) in Saudi Arabia, and 3.7% (44/1200) in Greece …”

Frequency of Red Blood Cells Alloimmunization in Thalassemia Patients at King Abdulaziz University Hospital in Jeddah, Saudi Arabia

“…The frequency of alloimmunization depends on the heterogeneity of the donor-recipient population and the RBC administration matching process. Numerous studies have reported a wide frequency range of alloimmunization in thalassemia patients: 30% (57/190) in Kuwait, 4.97% (8/161) in India, 5% (72/1435) in Italy, 26.25 % (84/320) in Egypt, 22.06% (16/68) in Saudi Arabia and 3.7% (44/1200) in Greece [10][11][12][13][15][16][17][18][19][20][21] .…”