Preventing delayed hemolytic transfusion reactions in sickle cell disease

Complement activation during intravascular hemolysis: Implication for sickle cell disease and hemolytic transfusion reactions

“…With regard to DHTRs, anti-complement therapies appear to be even more promising and the pioneering clinical experience is already available (78,80,82,83), Table 1. The main issue in DHTRs is that, despite an extended antibody screening and a cross-match, the evanescent antibodies might be undetectable before transfusion, especially in occasionally-transfused patients (120)(121)(122). Moreover, in some DHTRs, no antibodies are detectable whatsoever (72).…”

Health literacy and knowledge of chronic transfusion therapy in adolescents with sickle cell disease and caregivers

“…Recent studies have demonstrated that transfusion therapy at multiple hospital locations is common in alloimmunized adult patients, and that the majority of cases have discrepancies in RBC antibody detection at different locations and times, thus presenting a major threat for delayed hemolytic transfusion reactions . Currently, there is no commonly shared database of RBC alloimmunization history for patients in the United States, which poses a danger for alloimmunized patients who receive transfusion therapy at multiple hospitals . When patients lack knowledge of their RBC antibody and transfusion histories, they are at increased risk of delayed hemolytic transfusion reactions and death .…”

“…32,41 Currently, there is no commonly shared database of RBC alloimmunization history for patients in the United States, which poses a danger for alloimmunized patients who receive transfusion therapy at multiple hospitals. 43 When patients lack knowledge of their RBC antibody and transfusion histories, they are at increased risk of delayed hemolytic transfusion reactions and death. 11 Thus, assessing and providing individualized education for transfused patients with SCD and caregivers are essential steps to promote self-efficacy and successful outcomes following transition to adult care.…”

Fatal Delayed Hemolytic Transfusion Reaction and Hyperhemolysiswithout Detectable Alloantibodies or Autoantibodies in a Patient withSickle Cell Disease: A Case Report and Literature Review

“…It is often caused by a secondary immune response to an antigen on the donor's erythrocytes and leads to the destruction of transfused erythrocytes [3,9,13]. This complication has a reported incidence of 3% to 7% in transfused SCD patients, and 4% to 12% of DHTRs may be fatal [14]. Other DHTR cases with no detectable anti-RBC antibodies were reported in the literature in approximately 30% of cases, but the pathophysiological mechanism mediating red cell destruction is still unclear [3,15].…”

“…In such cases, intravenous immunoglobulin (IVIG) and Erythropoietin (EPO) should be administered concurrently [7]. For severe cases, EPO-Eculizumab should be considered [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. In cases where additional transfusions are necessary, EPO-Rituximab may prove successful [3].…”