Should Chronic Transfusions Be Matched for Antigens Other than ABO and Rh<sub>o</sub>(D)?

Blumberg, Neil; Ross, Karen C.; Avila, Eduardo; Peck, Kathy

doi:10.1111/j.1423-0410.1984.tb01587.x

Cited by 67 publications

(41 citation statements)

References 5 publications

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“…On the other hand, the alloimmunization rate in two studies done in Greece [11] and Kuwait [6] was 22% and 30% respectively. The higher alloimmunization rate in these two studies was probably due to the heterogeneity of the populations living in Greece and Kuwait and mismatched RBC phenotypes between donors and recipients.…”

Section: Discussionmentioning

confidence: 99%

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

Ahmed¹,

Hasan²,

Ragab³

et al. 2010

aoms

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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.

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Section: Discussionmentioning

confidence: 99%

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

Ahmed¹,

Hasan²,

Ragab³

et al. 2010

aoms

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“…Alloimmunization to red cell antigens in thalassemia has been repeatedly reported [2][3][4][5] to be lower than 10%. However, the serological and clinical problems we encountered were more frequent and serious than this low frequency could explain.…”

Section: Introductionmentioning

confidence: 99%

Alloimmunization to Red Cell Antigens in Thalassemia: Comparative Study of Usual versus Better-Match Transfusion Programmes

Michail-Merianou

Pamphili-Panousopoulou

Piperi-Lowes

et al. 1987

Vox Sanguinis

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Transfusion records and serological data concerning 120 regularly transfused thalassemic children were followed up, beginning with their first transfusion, for a 5-year period. All patients had been phenotyped for 18 red cell antigens before their first transfusion. The usual-match (UM) group consisted of 64 children who received blood compatible with their ABO and Rho (D) antigens. The better-match (BM) group comprised 56 children who received blood compatible with ABO, CcDEe and K antigens. It was found that a statistically significant difference does not exist in the overall frequency of alloimmunization between the UM (23.43%) and BM group (14.28%) and also between the children that started transfusion therapy before they were 12 months old regarding UM (9%) and BM policies (5.2%). However, a large numerical difference, which might become statistically significant with a larger number of patients was observed in the group of children who were started on transfusions after they were 12 months old, between the UM (38.7%) and BM (18.9%) policy. Finally, a statistically significant difference (<0.005) was found only between the children that started transfusions early (7.69%) and those that started them later in life (27.9%), irrespective of the transfusion policy observed. We report, in this study, the mean transfusion numbers of immunized and nonimmunized patients and the frequency, specificity and clinical significance of the identified antibodies are analyzed. Our conclusion is that a BM policy in transfusion programmes, including at least the Rhesus and Kell antigens, is recommended for all thalassemic children that start transfusion therapy after they are 12 months of age; if they start earlier, observation of the BM policy is not necessary.

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“…those of the Rh other then D, Kell, Duffy, Kidd and perhaps, Lewis systems must be taken into account in an attempt to prevent alloimmunization in patients requiring multiple transfusions [5][6][7][8]. Other investi-@ 1990 S. Karger AG, Basel w47-9007 l90t 0s8L-0050 $ 2.7sl0 gators, who found relatively low rates of alloimmunization, consider that extending compatibility to include antigens other than AB0 and Rh-D would not be cost effective [9]'…”

Section: Introductionmentioning

confidence: 99%

Red Cell Ailoantibodies in Patients with Thalassemia

Spanos¹,

Karageorga²,

Ladis³

et al. 1990

Vox Sanguinis

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We present the results of tests carried out to detect alloimmunization against red cells in 1,200 patients (607 males and 593 females), transfused and followed up during the period 1981:1987 in our hospital. Of these patients, 1,135 were thalassemic and 65 had sickle cell/β-thalassemia. In 162 patients who received blood matched for the AB0, rhesus and Kell systems from their first transfusion, the immunization rate was very low (3.7%).In a pilot group consisting of 83 patients with the same clinical characteristics, who received blood matched only for the AB0 and Rh-D antigens, there was a significant difference in the frequency of alloantibodies (15.7%, p<0.001). Of 1,038 patients who received blood only matched for AB0 and Rh-D 244 (23.5%) with one or more red cell alloantibodies were identified. Of these 1,038 patients, 973 were exclusively thalassemic. In 220 (22.6%) of them, alloantibodies were found. The sickle cell B-thalassemia patients presented alloantibodies with a higher frequency (36.9%, 24/65). Only one antibody was found in 114 patients (51.8%) and two or more in 106 patients (48.2%). The alloimmunization significantly concerned the rhesus (34.0%) and Kell (29.8%) systems. Anti-Kell was most often identified (28.5%). Alloimmunization appears considerably lower in patients in whom blood transfusion is started before the age of 3 than in those in whom it is started after that age (20.9 vs. 47.5%, p<0.0001).

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Should Chronic Transfusions Be Matched for Antigens Other than ABO and Rh_o(D)?

Cited by 67 publications

References 5 publications

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

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

Alloimmunization to Red Cell Antigens in Thalassemia: Comparative Study of Usual versus Better-Match Transfusion Programmes

Red Cell Ailoantibodies in Patients with Thalassemia

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Should Chronic Transfusions Be Matched for Antigens Other than ABO and Rho(D)?

Cited by 67 publications

References 5 publications

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

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

Alloimmunization to Red Cell Antigens in Thalassemia: Comparative Study of Usual versus Better-Match Transfusion Programmes

Red Cell Ailoantibodies in Patients with Thalassemia

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Should Chronic Transfusions Be Matched for Antigens Other than ABO and Rh_o(D)?