Red cell alloantibodies in thalassemia major

Abstract

Clinical and serological data on 1435 Italian thalassemia major patients were collected during a cooperative study involving 19 centers in 10 regions. The main findings were as follows: 18 percent of the patients were under 6 years of age, 63 percent between 6 and 15, and 19 percent over 15. Forty-one percent had undergone splenectomy. Sixty-two percent of the patients were maintained at pretransfusion hemoglobin levels higher than 10 g per dl, 36 percent between 8 and 10 g per dl, and 2 percent below 8 g per dl. Overall, 5.2 percent of the patients had clinically significant red cell alloantibodies (136 alloantibodies in 74 patients). One-half of the immunized patients had more than one and one-fourth had more than two alloantibodies. The specificities of the 136 alloantibodies were almost exclusively confined to the common antigens of the Rh, Kell, Kidd, and Duffy systems, in that decreasing order of frequency. The antibody screening procedure, using a low-ionic-strength solution antiglobulin test against a three-red-cell panel and the patient's own red cells (autocontrol) with a serum to cell ratio of 100 to 1 was shown to be an adequate technique for red cell antibody detection.

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

“…In most reports from Western countries, RBC antibodies most commonly associated with alloimmunization in thalassaemia are directed against C, E and Kell antigens [6, 11,12]. Anti-D alloantibodies are also frequently reported even though most patients receive RBC products crossmatched for ABO and RhD blood groups worldwide.…”

“…The relative homogeneity of donor and recipient populations in Greece and Italy has been shown to contribute to lower alloimmunization rates for transfused patients with thalassaemia [11,12] compared to more heterogeneous populations in other countries, such as Kuwait [19] and Taiwan [14]. One study from USA reported an alloimmunization rate of 20.8 % in Asians patients with thalassaemia where only 5 % of local blood donors were Asian [5].…”

“…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].…”

Detection and Identification of Red Cell Alloantibodies in Multiply Transfused Thalassemia Major Patients: A Prospective Study

“…Various centers all around the world have reported different frequencies of alloimmunization. The frequency of red cell alloimmunization ranging from 3.1 to 30 % [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. The some of these reports have a high rate of alloimmunization [2,6,8,15] but majority of centers have reported low rate of alloimmunization [3, 12, 13, 16-18, 20, 21].…”

“…Some alloantibodies are hemolytic and may cause hemolytic transfusion reactions and limit the availability of further safe transfusion [2]. The most frequent detected antibodies are directed against Rhesus (Rh), Kell (K), Duffy (Fy), Kidd (Jk) system antigens, in order of frequency [3]. The reported incidence of alloimmunization in multiply transfused thalassemics patients was 3-30 % [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18].…”