Red cell alloimmunization in transfused patients: A silent epidemic revisited

Pandey, Himani; Das, Sudipta Sekhar; Chaudhary, Rajendra

doi:10.4103/0973-6247.137433

Cited by 24 publications

(15 citation statements)

References 16 publications

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“…However, the pathogenesis of RBC autoantibody formation after transfusion is not well understood. 32 Interestingly, our study revealed an unusual frequency of ABO blood groups with a higher percentage of blood groups A (40.42%) and AB (13.3%) and a lower percentage of group O (22.34%) compared to other Egyptian studies. A study conducted in Cairo by Hussein and colleagues 3 reported ABO blood group frequencies of 34% for group A, 32% for group O, and 6.6% for group AB.…”

Section: Discussioncontrasting

confidence: 48%

“…Autoantibodies were not detected in any of our patients; this can be attributed to the fact that all thalassemia patients in Fayoum University Hospital are routinely injected with steroid therapy before each transfusion as a prophylaxis against allergy and transfusion reactions. However, the pathogenesis of RBC autoantibody formation after transfusion is not well understood …”

Section: Discussionmentioning

confidence: 99%

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Study of red blood cell alloimmunization risk factors in multiply transfused thalassemia patients: role in improving thalassemia transfusion practice in Fayoum, Egypt

et al. 2016

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The study reemphasizes the need for cost-effective strategy for thalassemia transfusion practice in developing countries. Red blood cell antigen typing before transfusion and issue of antigen-matched or antigen-negative blood can be made available to alloimmunized multiply transfused patients. Early institution of transfusion therapy after diagnosis is another means of decreasing alloimmunization.

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Section: Discussioncontrasting

confidence: 48%

Section: Discussionmentioning

confidence: 99%

Study of red blood cell alloimmunization risk factors in multiply transfused thalassemia patients: role in improving thalassemia transfusion practice in Fayoum, Egypt

et al. 2016

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“…Few studies observed strong correlation between the number of blood units transfused and alloantibody formation. 7,14 While other studies found no relationship between the number of transfusions and alloimmunization rate. 8,15 Spanos T et al observed that the relation between the number of units of blood transfused and antibody formation is unknown in Thalassemia major but it is an important factor for increased alloimmunization.…”

Section: Discussionmentioning

confidence: 66%

Red cell alloimmunization in repeatedly transfused children with beta thalassemia major

Jeengar

Upadhyaya

Agarwal

et al. 2017

Int J Contemp Pediatr

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Background: The development of anti-red blood cell alloantibodies remains a major problem in thalassemia major patients. We studied the frequency of red blood cell (RBC) allo-immunization among Beta thalassemia major patients who received regular transfusions at our center and analyzed the factors, which may be responsible for development of these antibodies.Methods:An observational study was conducted in department of Pediatric Medicine, SMS Medical College, Jaipur. A total of 150 patients of Beta Thalassemia major who already received multiple transfusions were randomly selected and screening of Red Cell Alloantibodies was done by using SPRCA (solid phase red cell adhesion) method during May 2015 to April 2016. Statistical analysis was done using computer software (SPSS version 20 and primer). The qualitative data were expressed in proportion and percentages and the quantitative data expressed as mean and standard deviations. The difference in proportion was analysed by using chi-square test and the difference in means were analysed by using student t- Test. Significance level for tests were determined as 95% (P <0.05).Results: Total 150 cases were included. Male female ratio was 1.63:1, 10 cases (6.67%) were positive for alloantibodies. Among these 10 positive cases, 2 had positive family history and 3 had history of splenectomy. In allo-immunised cases mean age, mean age at first transfusion and total number of transfusions were significantly higher in comparison to non-allo-immunized cases.Conclusions:If patient has red cell alloantibody on regular interval screening then the antibody identification should be performed and corresponding antigen negative blood transfusion is strongly recommended in transfusion dependent thalassemia patients.

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“…The differences in these findings might be due to the splenectomy status of the patients and whether or not the patient received steroid treatment before each transfusion. However, the pathogenesis of RBC autoantibody formation after transfusion is not really understood …”

Section: Discussionmentioning

confidence: 99%

The prevalence, alloimmunization risk factors, antigenic exposure, and evaluation of antigen‐matched red blood cells for thalassemia transfusions: a 10‐year experience at a tertiary care hospital

et al. 2018

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The prevalence, alloimmunization risk factors, antigenic exposure, and evaluation of antigen-matched red blood cells for thalassemia transfusions: a 10-year experience at a tertiary care hospital BACKGROUND: Hemoglobin E-β 0 thalassemia and homozygous β 0 -thalassemia are the most common chronic transfusion-dependent thalassemias in Thailand. Patients with these conditions can experience clinical complications such as RBC alloimmunization. In this study we aimed to determine the prevalence, alloimmunization risk factors, antigenic exposure, and evaluation of antigen-(C, c, E, e, Mi a ) matched RBC transfusion. STUDY DESIGN AND METHODS: Thalassemia patients were recruited from a tertiary care hospital for 10 years from 2008 to 2017. The medical records of transfusion history were reviewed for red cell phenotype both of patients and donors, number of units transfused, and type of alloantibodies. RESULTS: A total of 383 thalassemia patients were identified (178 males and 205 females). The frequency of RBC alloantibodies was 19.3%. Some patients tested positive for more than one antibody type. Autoantibodies were detected in nine individuals. Anti-E (49 [39.5%]), anti-Mi a (24 [19.4%]), and anti-c (19 [15.3%]) were the most common antibodies detected. A high rate of alloimmunization was found in splenectomized patients. Risk of alloimmunization increased when more total units of blood had been transfused. A trend toward low alloimmunization rates was noted in the antigen-matched RBC group, where 3.5% (5/143) of patients were alloimmunized. Anti-E and anti-Mi a , which may be naturally occurring, were identified in this group.CONCLUSION: Thai patients are more prone to develop antibodies against the Rh and Mi a than to the Kell blood group antigens.

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Red cell alloimmunization in transfused patients: A silent epidemic revisited

Cited by 24 publications

References 16 publications

Study of red blood cell alloimmunization risk factors in multiply transfused thalassemia patients: role in improving thalassemia transfusion practice in Fayoum, Egypt

Study of red blood cell alloimmunization risk factors in multiply transfused thalassemia patients: role in improving thalassemia transfusion practice in Fayoum, Egypt

Red cell alloimmunization in repeatedly transfused children with beta thalassemia major

The prevalence, alloimmunization risk factors, antigenic exposure, and evaluation of antigen‐matched red blood cells for thalassemia transfusions: a 10‐year experience at a tertiary care hospital

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