Alloimmunization and Erythrocyte Autoimmunization in Transfusion-dependent Egyptian Thalassemic Patients

Saied, Dalia A.; Kaddah, A. M.; Eldin, Reem M. Badr; Mohaseb, Safaa S.

doi:10.1097/mph.0b013e3182208154

Cited by 34 publications

(42 citation statements)

References 25 publications

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“…[26] reported a significant association between alloimmunization and gender, as they found alloimmunization to be associated more with female patients while on the other hand Saied et al . [27] found more association in male patients.…”

Section: Discussionmentioning

confidence: 99%

“…[1222] Schonewille et al .,[29] Saied et al . [27] and Ahmed et al . [30] found no significant association between alloantibodies and autoantibodies formation and the number of transfused packed RBCs.…”

Section: Discussionmentioning

confidence: 99%

“…[12616192730] However, no anti-Kell antibodies were reported by Pradhan et al .,[15] (Mumbai, India) in their study on thalassemia patients.…”

Section: Discussionmentioning

confidence: 99%

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Alloimmunization and autoimmunization in transfusion dependent thalassemia major patients: Study on 319 patients

Dhawan¹,

Kumawat²,

Marwaha³

et al. 2014

Asian J Transfus Sci

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Background:The development of anti-red blood cell antibodies (both allo-and autoantibodies) remains a major problem in thalassemia major patients. We studied the frequency of red blood cell (RBC) alloimmunization and autoimmunization among thalassemia patients who received regular transfusions at our center and analyzed the factors, which may be responsible for development of these antibodies.Materials and Methods:The study was carried out on 319 multiply transfused patients with β-thalassemia major registered with thalassemia clinic at our institute. Clinical and transfusion records of all the patients were examined for age of patients, age at initiation of transfusion therapy, total number of blood units transfused, transfusion interval, status of splenectomy or other interventions. Alloantibody screening and identification was done using three cell and 11 cell panel (Diapanel, Bio-rad, Switzerland) respectively. To detect autoantibodies, autocontrol was carried out using polyspecific coombs (IgG + C3d) gel cards.Results:Eighteen patients out of total 319 patients (5.64%) developed alloantibodies and 90 (28.2%) developed autoantibodies. Nine out of 18 patients with alloantibodies also had autoantibodies. Age at first transfusion was significantly higher in alloimmunized than non-immunized patients (P = 0.042). Out of 23 alloantibodies, 52.17% belonged to Rh blood group system (Anti-E = 17%, Anti D = 13%, Anti-C = 13%, Anti-Cw = 9%), 35% belonged to Kell blood group system, 9% of Kidd and 4% of Xg blood group system.Conclusion:Alloimmunization was detected in 5.64% of multitransfused thalassemia patients. Rh and Kell blood group system antibodies accounted for more than 80% of alloantibodies. This study re-emphasizes the need for RBC antigen typing before first transfusion and issue of antigen matched blood (at least for Rh and Kell antigen). Early institution of transfusion therapy after diagnosis is another means of decreasing alloimmunization.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Alloimmunization and autoimmunization in transfusion dependent thalassemia major patients: Study on 319 patients

Dhawan¹,

Kumawat²,

Marwaha³

et al. 2014

Asian J Transfus Sci

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“…[9] A high rate of approximately 20% was noted in studies by Spanos et al ,[8] Michail-Merianou et al ,[12] Singer et al ,[13] and Ameen et al . [14]…”

Section: Discussionmentioning

confidence: 99%

Detection of alloimmunization to ensure safer transfusion practice

Sood

Makroo

Riana

et al. 2013

Asian J Transfus Sci

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Background:Serological safety is an integral part of overall safety for blood banks. Emphasis is on the use of routinue Red Blood Cell (RBC) antibody screen test, at set time intervals, to reduce risks related to alloantibodies. Also emphasis is on importance of issuing antigen negative blood to alloantibody positive patients. Effect of using leucodepleted blood on the rate of alloimmunization is highlighted. The concept of provision of phenotypically matched blood is suggested.Materials and Methods:Antibody screen test is important to select appropriate blood for transfusion. Repeat antibody screen testing, except if time interval between the earlier and subsequent transfusion was less than 72 hours, followed by antibody identification, if required, was performed in patients being treated with repeat multiple blood transfusions. Between February 2008 and June 2009, repeat samples of 306 multi-transfused patients were analyzed. Search for irregular antibodies and reading of results was conducted using RBC panels (three-cell panel of Column Agglutination Technology (CAT) and two cell panel of the Solid Phase Red Cell Adherence Technology (SPRCAT). Specificities of antibodies were investigated using appropriate panels, 11 cell panel of CAT and 16 cell panel of SPRCA. These technologies, detecting agglutination in columns and reactions in solid phase, evaluate the attachment of irregular incomplete antibody to antigen in the first phase of immunological reaction more directly and hence improve the reading of agglutination. Three to four log leuco reduced red blood cells were transfused to patients in the study using blood collection bags with integral filters.Results:Alloimmunization rate of 4.24% was detected from 306 multiply transfused patients tested and followed up. The Transfusion therapy may become significantly complicated.Conclusion:Red cell antibody screening and identification and subsequent issue of antigen negative blood have a significant role in improving blood safety. Centers that have incorporated antibody screen test and identification have ensured safe transfusion. Identified patients should be flagged in a database and information shared. Such patients can be given carry-on cards and educated about the names of the identified antibodies. Full red cell phenotyping of individuals, patients and donors, can be feasibility.

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“…72 According to various reports, the rate of alloimmunisation among TM patients ranges from 5.2-37%, although it appears to be lower among more homogeneous populations. 44,60,[73][74][75][76][77][78] This variation has been linked to the extent of the homogeneity between the donor-recipient populations, divergent testing methods and differences in the patient population of each study. 75,79 Other factors include the use of non-leukoreduced RBC units and differences in providing antigenmatched blood.…”

Section: 43mentioning

confidence: 99%

Transfusion in Haemoglobinopathies: Review and recommendations for local blood banks and transfusion services in Oman

Al-Riyami

Daar

2018

Sultan Qaboos Univ Med J

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Sickle cell disease and homozygous β-thalassaemia are common haemoglobinopathies in Oman, with many implications for local healthcare services. The transfusions of such patients take place in many hospitals throughout the country. Indications for blood transfusions require local recommendations and guidelines to ensure standardised levels of care. This article summarises existing transfusion guidelines for this group of patients and provides recommendations for blood banks and transfusion services in Oman. This information is especially pertinent to medical professionals and policy-makers developing required services for the standardised transfusion support of these patients.

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Alloimmunization and Erythrocyte Autoimmunization in Transfusion-dependent Egyptian Thalassemic Patients

Cited by 34 publications

References 25 publications

Alloimmunization and autoimmunization in transfusion dependent thalassemia major patients: Study on 319 patients

Alloimmunization and autoimmunization in transfusion dependent thalassemia major patients: Study on 319 patients

Detection of alloimmunization to ensure safer transfusion practice

Transfusion in Haemoglobinopathies: Review and recommendations for local blood banks and transfusion services in Oman

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