Clinically significant red blood cell antibodies in chronically transfused patients: a survey of Chinese thalassemia major patients and literature review

Cheng, C.K.; Lee, C.K.; Lin, Chen

doi:10.1111/j.1537-2995.2012.03570.x

Cited by 69 publications

(84 citation statements)

References 19 publications

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“…These alloimmunization rates can be termed as moderate. In contrast, low immunization rates are reported in blood donors (0.8 %) or other hospital base patients (1-2 %) [24,25]; or high alloimmunization rates of more than 20 % reported in thalassemics from China [7], USA and UK [6], USA [5], Taiwan [14], Arab [19] and in Sickle Cell Disease (SCD) patients [10]. The alloimmunization rates in other frequently transfused patients from our country have also been reported to be moderate i.e.…”

Section: Discussionmentioning

confidence: 94%

“…Unlike SCD, it is not known if variant RH genotypes that could predispose patients to alloimmunization are more prevalent in thalassaemia patients. Kell antibodies are identified less often in Chinese thalassaemia patients compared to Caucasians [7], however, antibodies against Mia and Mur antigens occur more frequently in Chinese and Southeast Asians [7,14]. Mia and Mur antigens are part of the Miltenberger subsystem in the MNS blood group and can be associated with severe haemolytic disease of the newborn as well as haemolytic transfusion reactions.…”

Section: Discussionmentioning

confidence: 99%

“…The risks of red blood cell (RBC) antigen alloimmunization in thalassemia patients are considerably greater than those in general population as evident from alloimmunization rates of 4-50 % reported in studies from various centers involved in management of these patients [5][6][7][8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Red Blood Cell Antibodies in Thalassemia Patients in Northern India: Risk Factors and Literature Review

Elhence

Solanki

Verma

2014

Indian J Hematol Blood Transfus

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Study of the factors responsible for red cell alloimmunization can help in adopting appropriate strategy to minimize alloimmunization. However data for thalassemia patients from our region is limited. Therefore, a study was conducted to find out the frequency and the factors associated with red cell allo and autoimmunization in thalassemia patients at our center so as to enable us to take appropriate action to reduce alloimmunization. Clinical, demographic, allo and autoantibody and transfusion records of 280 thalassemia patients at our hospital were studied. Patients with and without alloantibodies were compared to find significant differences for age, gender, race, age at start of regular transfusions and splenectomy. Red cell antigen frequencies in thalassemia patients and published antigen frequencies in blood donors from the same center were compared to look antigen differences as a risk factor for alloimmunization. Twenty four thalassemia patients (8.6 %) developed 28 clinically significant alloantibodies. 18 (65 %) of the alloantibodies were of Rh system. The three most common antibodies detected was anti E (11, 39.3 %) followed by anti K (6, 21.4 %) and anti c (10.8 %). Five (1.8 %) of the 280 patients developed autoantibodies. Patient age was found to be significantly higher in alloimmunized patients than in non alloimmunized patients. Red cell antigen frequencies between blood donor and recipient populations were found to be homogenous for most of the relevant RBC antigens. The frequency of red cell alloimmunization in thalassemia patients from our center is moderate. In this setting of red cell phenotype concordant donor-recipient population requirement of extended phenotype matched transfusions may not be cost effective.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Red Blood Cell Antibodies in Thalassemia Patients in Northern India: Risk Factors and Literature Review

Elhence

Solanki

Verma

2014

Indian J Hematol Blood Transfus

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“…In other less transfused groups, alloimmunisation is between 1-10%. The prevalence depends largely on how often antibody screening and identification were performed (Alves et al, 2012 ;Cheng et al, 2012 ;Schonewille et al, 2006 ;Santos et al, 2007;Melanie and Shulman, 2005 ;Aygun et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of red blood cell antibodies among transfused patients at Komfo Anokye teaching (Kath) hospital, Ghana

Antwi-Boateng¹,

Schonewille²,

Sackey³

et al. 2015

Jnl Sci Tech

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Red blood cell (RBC) alloimmunisation is a common problem in transfused patients because of the possibility of haemolytic reaction and limited availability of compatible blood. In highincome countries, pre-transfusion antibody screening is performed routinely. In Ghana, patients are transfused with ABO Rh 'D' compatible blood without screening for immune antibodies. We therefore studied the prevalence and specificities of RBC antibodies in transfused patients at Komfo Anokye Teaching hospital, Ghana. The study was cross-sectional, involving previously transfused patients who required another transfusion. Participants' basic data on demography and transfusion history were recorded. Blood samples were screened and subsequently typed for RBC antibodies using a column gel agglutination test. A total of 106 transfused patients, 52 male and 54 females were enrolled. The patients had previously received a median of 4 RBC units (range 1-14). Of these, ten patients (9.4%) had 11 RBC alloantibodies, whose specificities were 2 anti-K; 2 anti-C; one each of anti-D, -E, -M, and -S; and 3 were pan-reactive. The number of transfusion episodes was significantly associated with the rate of alloimmunisation (p=0.000). In conclusion the overall alloimmunisation rate in the study was 9.4% and this was significantly associated with increasing number of transfusion episodes. Antibodies were mainly directed against antigens in the Rhesus system and K antigen. We recommend that antibody screening be incorporated into routine pre-transfusion testing procedures in Ghana.

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“…A incidência de aloimunização eritrocitária entre pacientes com talassemia que requerem transfusões crônicas está entre 5,2 a 23,5% (CHENG, et al, 2012). No entanto, anticorpos contra antígenos de muita alta frequência ou muita baixa frequência, como anti-Coltonb (anti-Cob) e anti-Lutheran14 (anti-Lu14) são raros.…”

Section: Introductionunclassified

Identificação de anticorpos anti-eritrocitários de baixa frequência em paciente politransfundida com beta-talassemia: relato de caso

Ferreira

Nomura

Dias

et al. 2015

Semin. Cienc. Biol. Saude

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A taxa de aloimunização eritrocitária em pacientes politransfundidos pode atingir 50%, entretanto a frequência de anticorpos clinicamente relevantes em pacientes transfundidos não é perfeitamente conhecida, estimando-se que cerca de 1% dos pacientes são sensibilizados a cada unidade de hemácias transfundidas. O objetivo deste trabalho é relatar o caso de uma paciente de 11 anos de idade, portadora de β-talassemia major, politransfundida, na qual foi detectada, em protocolo pré-transfusional, a presença de dois anticorpos anti- . Para o levantamento do histórico clínico-laboratorial da paciente, foi realizada pesquisa de prontuário arquivado no sistema de arquivos de um hospital-escola no qual a paciente é acompanhada. A fenotipagem eritrocitária em pacientes politransfudidos é essencial para minimizar os riscos de complicações devido à aloimunização e estimar a disponibilidade de sangue compatível. Assim, o relato do presente caso poderá contribuir para ampliar os conhecimentos sobre a real taxa de frequência de anticorpos anti-eritrocitários raros em paciente talassêmico. ResumoPalavras-chave: Beta-talassemia. Aloimunização. Anticorpos raros. Anti-Colton b. Anti-Lutheran 14. AbstractThe rate of erythrocyte alloimmunization in tranfusion-dependent patients can reach 50%, although the frequency of clinically relevant antibodies in transfused patients is not fully known, it is estimated that about 1% of patients are sensitized to each unit of transfused RBCs. The aim of this study is to report the case of an 11-year-old girl with β-thalassemia major, chronically transfused, which was detected in pre-transfusion protocol, the presence of two rare anti-erythrocyte antibodies: anti-Colton b (anti-Co b ) and anti-Lutheran 14 ). To survey the clinical and laboratory patient history, research records filed in the archives of the university hospital in which the patient is monitored system was performed. The phenotyping erythrocyte in multitransfused patients is essential to decrease the risk of complications due to alloimmunization and estimate the availability of compatible blood. Thus, the report of this case may contribute to increase knowledge about of the real frequency of uncommon anti-erythrocyte antibodies in thalassemic patients.

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Clinically significant red blood cell antibodies in chronically transfused patients: a survey of Chinese thalassemia major patients and literature review

Cited by 69 publications

References 19 publications

Red Blood Cell Antibodies in Thalassemia Patients in Northern India: Risk Factors and Literature Review

Red Blood Cell Antibodies in Thalassemia Patients in Northern India: Risk Factors and Literature Review

Prevalence of red blood cell antibodies among transfused patients at Komfo Anokye teaching (Kath) hospital, Ghana

Identificação de anticorpos anti-eritrocitários de baixa frequência em paciente politransfundida com beta-talassemia: relato de caso

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