Study of the Frequency and Specificity of Red Cell Antibodies in Patients with Hemoglobinopathies

Abstract

Patients with thalassemia and sickle cell disease (SCD) require blood transfusions as part of their supportive care. However, one of the most serious side effects of this treatment is the risk of red cell alloimmunization. The goal of this study was to assess the prevalence and Specificity of red cell alloimmunization in Egyptian thalassemia and sickle cell anaemia patients. This study included 200 multi transfused Egyptian patients, one hundred and forty patients with transfusion dependent thalassaemia and sixty patients with sickle cell anaemia, who were attending the Paediatric Children Hospital-Cairo University at the period from March 2019 to October 2019. Alloantibody identification was made by Diamed- ID microtyping system. In the studied groups both thalassemia and sickle patients, the prevalence of alloimmunization was 22/200 (11%) patients. The two most often alloantibodies were, antibodies against Kell antigen (37%) and against E antigen (30%). The prevalence of alloimmunization was more in females in comparison to males, but it did not reach statistical significance and patients with thalassemia major had higher alloimmunization rates than other studied groups but was not statistically significant. In the D negative patients in the research group, alloimmunization demonstrated a statistically significant difference (p = 0.01). Age, gender, age of transfusion onset and splenectomy were not contributing factors to the antibody presence in the group of patients being investigated. Before receiving blood transfusions, extended red blood cell phenotyping should be thought of as a crucial procedure for hemoglobinopathies patients who would likely have several transfusions. It is advised that haemoglobinopathies patients in Egypt be checked through phenotyping of RBC units for Kell and all Rh antigens to be phenotyped before starting transfusion in these patients which is also standard of care for these patients presently.

Red blood cell alloimmunization in blood transfusion-dependent β thalassemia major patients in Sana’a City-Yemen

“…A recently cohort study reported that a total of 27 alloantibodies with 9 specificities were identified in both sickle cell anemia and thalassemia patients. The most frequent alloantibodies in thalassemia patients were anti-K (47%) followed by anti-E (23.5%) 26 . A similar study conducted in Egypt by Osman et al discovered that anti-K (37.3%) and anti-E (34.3%) were also the most prevalent alloantibodies in thalassemia patients 27 .…”

“…Female gender is a significant independent risk factor for alloimmunization, particularly for those who may become pregnant or give birth in the future. As a result of previous alloimmunization, these patients may also have a higher incidence of hemolytic disease in their newborns 26 .…”