Frequency of Red Cell Alloimmunization Among Patients with Transfusion Dependent Beta Thalassemia in Pakistan

Usman, Muhammad

doi:10.4999/uhod.09134

Cited by 10 publications

(8 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This finding was consistent with the results from other studies [8,28]. Furthermore, several studies had reported no significant association between splenectomy and the development of RBC alloantibodies [4,29,30]. On the other hand, Ahmed et al [2] and Thompson et al [31] reported a significant association of splenectomy in thalassemia patients with both RBC alloantibodies and autoantibodies.…”

Section: Discussionsupporting

confidence: 89%

Prevalence and clinical significances of red cell alloimmunization and red cell bound immunoglobulin G in polytransfused patients with thalassemias

2018

View full text Add to dashboard Cite

The study was to determine the prevalence and clinical significances of red blood cell (RBC)bound IgG as detected by flow cytometry in polytransfused patients with thalassemias. Relationship of the presence of RBC-bound IgG with RBC alloimmunization was also evaluated. This study included 59 polytransfused patients with β-thalassemia disease. We studied the frequency of RBC autoantibodies and alloimmunization. Direct Coombs test and flow cytometry were performed to detect the presence of RBC autoantibodies while RBC alloantibodies were detected by antibody screening and identification assays. Eight (13.6%) and 34 (57.6%) patients were found a positive direct Coombs test and flow cytometry, respectively. Twenty (33.9%) patients developed RBC alloantibodies. The four most frequent RBC alloantibodies were anti-E (55%), anti-Mia (40%), anti-Di(a) (25%) and antic (15%), respectively. There was no significant difference in the presence of RBC-bound IgG between polytransfused with thalassemia patients who developed RBC alloimmunization (13 of 20; 65%) and those without RBC alloantibodies (21 of 39; 53.8%), p = 0.412. Splenectomy and increased transfusion requirement were significantly associated with the presence of RBC-bound IgG but not with RBC alloantibody formation. The overall frequency of RBC alloantibody formation in polytransfused patients with thalassemias was 33.9%. The most common RBC alloantibody was anti-E. RBC autoantibody formation was more frequently detected by flow cytometry (57.6%) than by direct Coombs test (13.6%). Splenectomy was significantly associated with the development of autoreactive RBC-bound IgG antibodies in the polytransfused patients with thalassemias. The presence of the anti-RBC autoantibodies may cause an increase of transfusion requirement.

show abstract

Section: Discussionsupporting

confidence: 89%

Prevalence and clinical significances of red cell alloimmunization and red cell bound immunoglobulin G in polytransfused patients with thalassemias

2018

View full text Add to dashboard Cite

show abstract

“…This finding is in agreement with other studies including Usman et al, (2011) andHiggins andSloan (2008). However, Winters et al (2001), Bauer et al (2007) and Verduin et al (2012), observed contrasting results.…”

Section: Our Findings Suggest Alloimmunisation Is Notsupporting

confidence: 93%

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

View full text Add to dashboard Cite

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.

show abstract

“…The frequency of alloimmunization in our thalassemia patients (16.32%) was lower than that reported in thalassemia patients from Taiwan (37%), Egypt (28.4%), and Kuwait (30%)[ 4 7 8 ] but was higher than the frequency reported in patients from Pakistan (3.75%), Italy (5.2%), Greece (3.7%), India (5.64%), and Malaysia (8.6%). [ 18 19 20 21 22 ] One of the most important reasons for the relatively high alloimmunization rate in our thalassemia patients may be transfusion of nonleukoreduced RBC units in a number of patients. As indicated in Table 5 , over 50% of our alloimmunized thalassemia patients received nonleukoreduced RBC units.…”

Section: Discussionmentioning

confidence: 99%

Study of alloimmunization and autoimmunization in Iranian β-thalassemia major patients

Davari

Soltanpour

2016

Asian J Transfus Sci

View full text Add to dashboard Cite

Background:Thalassemia is one of the most common monogenic disorders characterized by reduced production of globin chains. Although regular red blood cell (RBC) transfusion support is the main treatment for these patients, it may be associated with complications such as RBC alloimmunization.Aim:The study aimed to determine the incidence of alloimmunization and autoimmunization to RBC antigens in β-thalassemia major patients from Zanjan, Zanjan Province, Iran.Materials and Methods:A total of 49 β-thalassemia major patients comprising 24 females and 25 males (mean age: 18.59 ± 8.16 years; range: 2-40 years) from Northwest Iran were included in a cross-sectional study. Alloantibody screening and identification were done using 3-cell and 10-cell reagent red blood cells, respectively. Autoantibody detection was performed using direct Coomb's test.Results:The incidence of alloimmunization was 16.32% with 10 alloantibodies identified in 8 patients. The most common clinically significant alloantibody identified in alloimmunized patients was anti-Kell (K-antigen) (60%) followed by anti-Rhesus (Rh) (E, c-antigens). The rate of alloimmunization was significantly lower in patients transfused with leukoreduced RBCs compared with those transfused with nonleukoreduced RBCs (9.53% vs 57.14%, P = 0.001). There was no significant correlation between alloantibody formation and the age, gender, hemoglobin levels, number of transfused units, and splenectomy.Conclusion:Transfusion of leukoreduced and phenotypically matched red blood cells for Kell (K) and Rh (E, c) antigens may help reduce the alloimmunization rate in Iranian β-thalassemia major patients. Moreover, autoimmunization to RBC antigens was rare in our patients.

show abstract

Frequency of Red Cell Alloimmunization Among Patients with Transfusion Dependent Beta Thalassemia in Pakistan

Cited by 10 publications

References 12 publications

Prevalence and clinical significances of red cell alloimmunization and red cell bound immunoglobulin G in polytransfused patients with thalassemias

Prevalence and clinical significances of red cell alloimmunization and red cell bound immunoglobulin G in polytransfused patients with thalassemias

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

Study of alloimmunization and autoimmunization in Iranian β-thalassemia major patients

Contact Info

Product

Resources

About