Human leucocyte antigen alloimmunisation in repeatedly transfused thalassemic Egyptian children and its relation to febrile non‐haemolytic transfusion reactions

Mourad, Zinab; Hassab, Hoda; Younan, Doreen N.; Abdo, Alaa El Din Mohamed

doi:10.1111/tme.12261

Cited by 5 publications

(4 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, some adverse effects such as viral transmission and alloimmunization can be seen in countries where blood and blood products are not safe. In our study, the frequency of alloimmunization was 10% among refugee patients with BT, which is similar to the frequency reported in other studies . Among 299 immigrant patients who had treatment in their own country, serologic analysis revealed hepatitis B antigenemia in 0.6% and antihepatitis C in 5.3% of patients.…”

Section: Discussionsupporting

confidence: 89%

Refugee children with beta‐thalassemia in Turkey: Overview of demographic, socioeconomic, and medical characteristics

Erdem

Yenigürbüz

Pekpak

et al. 2019

Pediatric Blood & Cancer

View full text Add to dashboard Cite

Aim Since the beginning of the Syrian civil war, more than 3.5 million Syrians have been under temporary protection status in Turkey. Because beta‐thalassemia (BT) is a prevalent disorder in the Mediterranean countries, we decided to estimate the prevalence of and make an overview of the demographic, socioeconomic, medical characteristics, and healthcare problems of refugee children with BT. Patients Eighteen Turkish Pediatric Hematology Oncology Centers (PHOC) with 318 refugee children from 235 families participated in the study. The mean age of the patients was 8.1 ± 4.8 years (0.5–21 years). The mean time after immigration to Turkey was 2.5 ± 1.5 years (range, 0.1–7 years). Seventy‐two (22.6%) of them were born and diagnosed with BT in Turkey. On physical examination, 82 patients (26%) were underweight and 121 patients (38%) were stunted. The appearance of a thalassemic face was reported for 207 patients (65.1%). Hepatomegaly and splenomegaly were reported in 217 (68.2%) and 168 (52.8%) patients, respectively. The median ferritin level was 2508 ng/mL (range, 17–21 000 ng/mL) at the first admission, and 2841 ng/mL (range, 26–12 981 ng/mL) at the last visit after two years of follow‐up in a PHOC (P > 0.05). The most frequently encountered mutation was IVSI‐110 (G>A) (31%). Before immigration, only 177 patients (55.6%) reported the use of chelators; after immigration it increased to 268 (84.3%). Conclusion Difficulties in communication, finding a competent translator capable in medical terminology, nonregular use of medications, and insensitivity to prenatal diagnosis were preliminary problems. The current extent of migration poses emerging socioeconomic and humanitarian challenges for refugee patients with BT.

show abstract

Section: Discussionsupporting

confidence: 89%

Refugee children with beta‐thalassemia in Turkey: Overview of demographic, socioeconomic, and medical characteristics

Erdem

Yenigürbüz

Pekpak

et al. 2019

Pediatric Blood & Cancer

View full text Add to dashboard Cite

show abstract

“…It was previously reported that FNHTRs were associated with the increased levels of human leukocyte antigen (HLA) antibodies, and ATRs were related to the deficiency of antibodies including IgA, IgG, and IgE [ 17 ]. However, the associations are not common now because of the use of washed and filtered RBC, and irradiation-treated platelets [ 17 , 18 ]. A previous report has shown that HLA-DR mediated the production of IL-1β in human monocytes [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Platelet concentrate and type II IL-1 receptor are risk factors for allergic transfusion reactions in children

et al. 2020

Ital J Pediatr

View full text Add to dashboard Cite

Purpose: Allergic transfusion reactions (ATRs) are immunological reactions after transfusion. Interleukin-1 (IL-1) is a critical regulator for human diseases. We performed this study to investigate the association of type II IL-1 decoy receptor (IL1R2) expression with ATRs in children. Methods: Children received blood transfusions between January and December 2019 were included. The age, sex, number and type of blood transfusion, allergic history, and medical history were collected and statistically analyzed. The blood samples were collected from children with and without ATRs for detecting the relative expression IL1R2 mRNA. Logistics regression analysis was performed to identify the risk factors for ATRs in children. The area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the predictive performance of risk factors. Results: Totally, 28,840 transfusions in 20,230 children, with 236 ATRs (0.82%) in 117 patients (0.58%) were included. ATRs were common in children at the hematology-oncology department, in children received higher number of blood transfusions, and older children. Platelet concentrate induced a higher incidence of ATRs (3.31%) than red cell concentrate (0.22%, p < 0.0001). After the transfusion, IL1R2 mRNA level was higher in the blood samples in children with ATRs than those without ATRs (p < 0.0001). Logistics regression analysis indicated that platelet concentrate (95% CI 3.555, 293.782) and IL1R2 expression (95% CI 1.171 × 10 2 , 1.494 × 10 4) were independent risk factors for ATRs in children. IL1R2 expression had high performance in predicting ATRs (AUC = 0.998, 100% sensitivity and 98.85% specificity). Conclusion: High IL1R2 expression level in children who received blood transfusions may predict the morbidity of ATR.

show abstract

“…Consequently, the use of BCs slightly decreased; however, the demand for blood and blood products in developing countries, more particularly in the Eastern/Southern Mediterranean region, continues to grow as a result of several factors, including the expansion and aging of the population, and the availability of, and access to, increasingly sophisticated medical/surgical procedures . In addition, these countries are almost all in the “thalassaemia belt,” which accounts for the high prevalence of children born with transfusion‐dependent beta (β)‐thalassemia, and subsequently more prone to develop immune‐hematologic complications . Sickle cell disorders are also an important issue in this region affecting around 0.84 per 1000 births …”

Section: Introductionmentioning

confidence: 99%

“…6,7 In addition, these countries are almost all in the "thalassaemia belt," which accounts for the high prevalence of children born with transfusion-dependent beta (β)-thalassemia, 8 and subsequently more prone to develop immune-hematologic complications. 9,10 Sickle cell disorders are also an important issue in this region affecting around 0.84 per 1000 births. 11 Unlike low-income countries where the support of WHO is much needed, most of Eastern/Southern Mediterranean countries are not devoid of resources and can adequately manage blood transfusion services.…”

Section: Introductionmentioning

confidence: 99%

How to manage transfusion systems in developing countries: The Experience of Eastern and Southern Mediterranean countries

Haddad

Benajiba²,

Hmida³

et al. 2020

Transfusion Medicine

View full text Add to dashboard Cite

Objectives To outline and analyse the national organisation, infrastructure and management of transfusion systems in countries sharing common historical, cultural and economic features and to decipher management trends, in order to potentially benchmark. Background Little is known regarding transfusion systems in Eastern/southern Mediterranean at a time international organisations are calling for the establishment of a safe and sustainable blood system. Materials and Methods Data emanating from eight Arabic‐speaking Eastern/Southern Mediterranean countries who responded to five surveys were collected and tabulated. Results While similarities in terms of supervision by national authorities, authorization of blood centres, quality control and management information system are evident, some significant divergence between these countries do exists. Only Lebanon does not possess a national blood establishment or organisation for blood supply. Blood components are fully government‐subsidised in Algeria and Mauritania. Algeria, Morocco and Tunisia have a blood supply that relies mainly on Voluntary non‐remunerated donors. Plateletpheresis is performed in all countries except Mauritania while plasmapheresis exists only in Algeria and Egypt. Morocco is the sole country outsourcing its plasma for Plasma derived products. Conclusion Despite the various challenges facing these countries, lot of progresses have been made so far in the field of transfusion medicine. Yet, nationally coordinated blood programs overviewed by national regulatory authorities and actively supported by local governments are still needed to ensure the optimum level of blood safety.

show abstract

Human leucocyte antigen alloimmunisation in repeatedly transfused thalassemic Egyptian children and its relation to febrile non‐haemolytic transfusion reactions

Cited by 5 publications

References 7 publications

Refugee children with beta‐thalassemia in Turkey: Overview of demographic, socioeconomic, and medical characteristics

Refugee children with beta‐thalassemia in Turkey: Overview of demographic, socioeconomic, and medical characteristics

Platelet concentrate and type II IL-1 receptor are risk factors for allergic transfusion reactions in children

How to manage transfusion systems in developing countries: The Experience of Eastern and Southern Mediterranean countries

Contact Info

Product

Resources

About