BackgroundAlloantibody production is one of the most challenging complications in transfusion‐dependent thalassaemia patients. Haemolytic anaemia, an increase in blood consumption, difficulty in haematopoietic stem cell transplantation and reduced quality of life are consequences of alloimmunisation. The most predisposed antigens (Ags) for alloantibody development are Rh and Kell blood group Ags.ObjectiveThe aim of the present study is to evaluate any correlation between HLA‐DRB1 alleles and Rh and Kell alloantibodies.Materials and MethodsFifty‐two non‐responders (control) and 54 responders (case) were enrolled in this study. Alloantibody detection was performed using the tube method. Genotyping of HLA‐DRB1*01 and HLA‐DRB1*15 was conducted by single‐specific primer‐polymerase chain reaction.ResultsIn the responder group, 77.8% were hyper‐responders (more than one alloantibody), and only 22.2% were mono‐responders. Most detected alloantibodies were Anti‐K (94.4%), followed by Anti‐E (64.8%), Anti‐C (29.6%) and Anti‐D (25.9%). There was a significant difference in HLA‐DRB1*15 between responder and non‐responder groups, 73.7% vs 26.3%, respectively. (P = .029, OR = 3.290; 95%CI). Our results showed that HLA‐DRB1*15 was more frequent in hyper‐responders than mono‐responders (92.9% vs 7.1%) (P = .007). The greatest HLA‐DRB1*15 was seen in Anti‐K (P = .014, odds ratio [OR = 3.784]; 95% confidence interval [CI]) and Anti‐E (P = .011, OR = 3.609; 95%CI) alloantibodies. There is no association between HLA‐DRB1*01 and alloimmunisation.ConclusionOur findings showed that there is a significant correlation between HLA‐DRB1*15 and Anti‐K and Anti‐E alloantibodies. These findings can be useful in detecting susceptible thalassaemic patients and improving transfusion management.
Immune thrombocytopenic purpura (ITP) is an autoimmune bleeding disorder associated with platelet destruction. Abnormalities in frequency and function of different immune cells can play a crucial role in this disease. The aim of this study was to evaluate the prognostic value of CD markers' expressions by immune cells in ITP. Peripheral blood samples were collected from 25 ITP patients before and after treatment. The expression of CD markers was evaluated by flow cytometry technique. The expression of CD38 and CD56 was significantly lower before treatment than after it (p = 0.025 and p = 0.036, respectively). Furthermore, a positive correlation was found between CD38 expression with platelet count before (r = 0.496, p = 0.012) and after treatment (r = 0.404, p = 0.045). No significant relationship was found between this marker and platelet count while CD4 expression was higher before treatment than after it (p = 0.002). In conclusion, CD38 may have independent prognostic value in ITP and we suggest that it can be a prognostic marker for this disease.
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