Fréquence de l’allo-immunisation érythrocytaire chez les malades polytransfusés au centre hospitalo-universitaire du Point G, Bamako, Mali

Baby, Mounirou; Fongoro, S; Cissé, Moussa; Gakou, Y.; Bathily, Moussa; Dembélé, A; Maïga, Mahamane Kalil; Tounkara, A.; Diallo, Dapa A.

doi:10.1016/j.tracli.2010.06.026

Cited by 17 publications

(15 citation statements)

References 9 publications

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“…24 In our study, the two mainly represented antibodies were co-associated (Anti-D+C) in 4 of 14 patients. The predominance of Rh group antibodies was also reported in some other west African countries, as well as in Côte d'Ivoire, 45 Mali, 26 Senegal 46 and Nigeria, 27,47 but in these studies, anti-E was the most often encountered when compared to anti-D and anti-C. Surprisingly, we found Rh anti-D antibodies, which could be due to errors occurring during patients' blood typing.…”

Section: Discussionsupporting

confidence: 61%

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Red blood cell alloimmunisation in multi-transfused patients from an haemodialysis service in Burkina Faso

Nébié

Sawadogo

et al. 2022

Afr. J. Lab. Med.

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Background: In Burkina Faso, red blood cell (RBC) transfusion remains the crucial anaemia treatment following chronic renal failure (CRF) as erythropoietin and its analogues are unavailable. However, blood group matching beyond the ABO and Rhesus is not common in Burkina Faso. Thus, alloimmunisation is a potential issue for transfused patients.Objective: Our study aimed to identify anti-erythrocyte antibodies in multi-transfused CRF patients at the Yalgado Ouedraogo Teaching Hospital, Ouagadougou, Burkina Faso.Methods: This cross-sectional study, conducted from October 2018 to November 2019, included CRF patients who had received at least two RBC units. We screened patients for the presence of RBC antibodies using three commercial Cells panels and identified antibody specificities for positive screenings using 11 Cells panels for an indirect antiglobulin test (IAT) in a low ionic strength microcolumn gel-card system.Results: Two hundred and thirty-five patients (45.1% female; average age: 41.5 years) were included. The median number of blood units received per patient was 10 (interquartile range: 5–20). The overall alloimmunisation rate was 5.9% (14/235). Antibodies identified included: anti-D (1 case), anti-C (1 case), anti-D+C (4 cases), anti-CW (1 case), anti-E (1 case), anti-S (1 case) and anti-Lea (1 case). In four positive patients, the specificity of the antibodies was indeterminate. No risk factors were associated with alloimmunisation.Conclusion: In Burkina Faso, screening for RBC alloantibodies should be mandated for patients at risk. The high rate of indeterminate antibodies suggests the need to develop a local RBC antibody panel adapted to the local population.

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Section: Discussionsupporting

confidence: 61%

“…However, some reported higher rates: Uganda in 2010 (10.2%), Mali in 2013 (10.3%) and Nigeria in 2015 (9.3%). 22,25,26,27,28 These results reflect the poor immunological safety of blood transfusions in sub-Saharan Africa, where blood transfusion is performed based only on the blood donor and recipient ABO and RhD antigens matching.…”

Section: Discussionmentioning

confidence: 99%

Red blood cell alloimmunisation in multi-transfused patients from an haemodialysis service in Burkina Faso

Nébié

Sawadogo

et al. 2022

Afr. J. Lab. Med.

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“…Finally, a majority (57%) of our donor population expressed the Rh formula of ccD.ee, which could partly explain why we did not find RBC alloantibodies directed against highly immunogenic antigens such as D or E. A study by Badjie et al, 29 conducted amongst 800 donors from various ethnic groups, found the prevalence of the ccD.ee phenotype to be 81.9% in East Africa and a study by Baby et al 30 found a prevalence of 67.9% in West Africa (Mali). These results suggest that a large proportion of donors – exceeding 50% – and transfusion recipients in Africa share equal Rh phenotypes, so that Rh antibodies may be less frequently induced than in other parts of the world.…”

Section: Discussionmentioning

confidence: 69%

Red cell allo- and autoimmunisation in transfused sickle cell and cancer patients in Kenyatta National Hospital, Nairobi, Kenya

et al. 2015

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BackgroundCurrently, no data are available on the prevalence of red blood cell (RBC) antibody formation amongst Kenyan patients with multiple transfusion needs, such as patients with sickle cell disease (SCD) or haematological malignancies (HM) and solid (SM) malignancies.ObjectivesWe determined the prevalence and specificities of RBC alloantibodies and autoantibodies in two patient groups with recurrent transfusion demands at Kenyatta National Hospital, Nairobi, Kenya.MethodBetween February and August 2014, 300 samples from SCD, HM and SM patients were collected and screened for alloantibodies. Samples from 51 healthy blood donors were screened for irregular antibodies and phenotyped.ResultsAmongst the 228 patients with viable samples (SCD, n = 137; HM, n = 48; SM, n = 43), the median transfusion frequency was two to three events per group, 38 (16.7%) were RBC immunised and 32 (14.0%) had a positive direct antiglobulin test. We identified specific alloantibodies in six patients (2.6%). Four of these six were SCD patients (2.9%) who had specific RBC alloantibodies (anti-Cw, anti-M, anti-Cob, anti-S); amongst HM patients one had anti-K and one had anti-Lea. RBC autoantibody prevalence was 3.1% (7/228). Amongst the healthy blood donors, the Ror, ccD.ee and R2r, ccD.Ee phenotypes accounted for 82% of the Rhesus phenotypes and all were Kell negative.ConclusionThe numbers of transfusions and the rates of RBC alloantibodies are low and the most important RBC alloantibody-inducing blood group antigens are relatively homogeneously distributed in this population. A general change in the Kenyatta National Hospital pre-transfusion test regimen is thus not necessary. The current transfusion practice should be reconsidered if transfusion frequencies increase in the future.

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“…Although transfusions are considerably safer nowadays [ 10 ], transfusion-related risks persist [ 11 – 13 ]. These risks include transmission of infectious agents [ 11 , 14 , 15 ], the development of alloimmunization [ 16 , 17 ], and iron overload [ 18 ]. Additionally, significant costs are associated with blood transfusions and EPO therapy to which few patients have access.…”

Section: Introductionmentioning

confidence: 99%

Blood Transfusion, Serum Ferritin, and Iron in Hemodialysis Patients in Africa

Rerambiah

Rérambiah

Etomba

et al. 2015

Journal of Blood Transfusion

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Background and Objectives. There is no data analyzing the outcome of blood transfusions and oral iron therapy in patients with kidneys failure in sub-Saharan Africa. The present study aimed to fill that gap and assess the value of ferritin in the diagnosis of iron overload and deficiency. Design. From January to February 2012, we prospectively studied 85 hemodialysis patients (78% of males and 22% of females aged 20 to 79 years) attending the Gabonese National Hemodialysis Centre. Results. Correlation studies showed (a) a strong positive linear relationship between the number of blood transfusions and high serum ferritin in hemodialysis patient (Spearman r : 0.74; P value: 0.0001); (b) a weak association between the number of blood transfusions and serum iron concentrations (Spearman r : 0.32; P value: 0.04); (c) a weak association between serum ferritin and serum iron (Spearman r : 0.32; P value: 0.003). Also, the strength of agreement beyond chance between the levels of ferritin and iron in the serum was poor (κ = 0.14). The prevalence of iron overload was 10.6%, whereas the prevalence of iron deficiency was 2.3%, comparing (1) patients with a maximum of one transfusion not on iron therapy; (2) patients with a maximum of one transfusion on iron therapy; (3) polytransfused patients not on iron therapy; and (4) polytransfused patients on oral iron therapy. The “Kruskal-Wallis test” showed that ferritin levels varied significantly between the groups (P value: 0.0001). Conclusion. Serum ferritin is not reliable as a marker of iron overload. For patients undergoing regular transfusion we recommend routine serum ferritin measurement and yearly measurement of LIC.

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Fréquence de l’allo-immunisation érythrocytaire chez les malades polytransfusés au centre hospitalo-universitaire du Point G, Bamako, Mali

Cited by 17 publications

References 9 publications

Red blood cell alloimmunisation in multi-transfused patients from an haemodialysis service in Burkina Faso

Red blood cell alloimmunisation in multi-transfused patients from an haemodialysis service in Burkina Faso

Red cell allo- and autoimmunisation in transfused sickle cell and cancer patients in Kenyatta National Hospital, Nairobi, Kenya

Blood Transfusion, Serum Ferritin, and Iron in Hemodialysis Patients in Africa

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