Red cell alloimmunization and autoantibodies in Egyptian transfusion-dependent thalassaemia patients

Abstract

IntroductionThe objective of this study was to explore the frequency of red cell alloantibodies and autoantibodies among β-thalassaemia patients who received regular transfusions.Material and methodsThis study included 501 patients with β-thalassaemia. This work planned to study the presence of alloantibodies and autoantibodies to different red cell antigens in multitransfused thalassaemia patients using the ID. Card micro typing system.ResultsOf a total of 501 β-thalassaemia patients included in the study, 11.3% of patients developed alloantibodies; 9.7% of these alloantibodies were clinically significant. The most common alloantibodies were anti-K, anti-E and anti-C. The rate of incidence of these alloantibodies was 3.9%, 3.3% and 1.7% respectively. Autoantibodies occurred in 28.8% of the patients and 22.1% of these antibodies were typed IgG. There was a significant association between splenectomy with alloimmunization and autoantibody formation (p = 0.03, p = 0.001 respectively). There was no significant association between alloantibody, autoantibody formation and number of transfused packed red cells.ConclusionsAlloimmunization to minor erythrocyte antigens and erythrocyte autoantibodies of variable clinical significance are frequent findings in transfused β-thalassaemia patients. There is an association between absence of the spleen and the presence of alloimmunization and autoantibody formation.

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

“…In our study frequency of autoimmunization was found to be 1.8 %. In a study by Ahmed et al the incidence of autoantibodies in thalassemics was 28.8 % [28]. Their data was similar to an Asian study which reported autoantibodies in 25 % of their thalassaemia patients [5].…”

Early occurrence of red blood cell alloimmunization in patients with sickle cell disease

“…It has been suggested that the immune response to foreign antigens may be hampered at an early age, or that early exposure to foreign RBC antigens may induce a form of immune tolerance to allogeneic antigens [42][43][44][45]. In addition, splenectomy has been associated with an increased risk of alloimmunization in patients with thalassemia [46,47]. In SCD progressive splenic dysfunction occurs at young age.…”

Alloimmunization and Erythrocyte Autoimmunization in Transfusion-dependent Egyptian Thalassemic Patients

“…10 A marked absolute lymphocytosis, accompanied by an increase in serum immunoglobulins, immune complexes, and cells bearing surface immunoglobulins, was reported with the use of both leukoreduced and nonleukoreduced blood, predominantly in splenectomized patients. 11,12 Formation of autoantibodies against RBCs, in association with RBC alloimmunization, has been documented in previous studies, resulting in clinical hemolysis, and difficulty in cross-matching blood, and shortening of the duration of RBC's survival. 1,13 In addition to the traditional practice of providing antigen-negative blood, only after the patient has made an antibody, novel approaches include providing fully antigenmatched blood (ie, matched for D, C, E, c, e, K, FYa, FYb, JKa, and JKb antigens).…”