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Red cell alloimmunisation in regularly transfused beta thalassemia patients in Pakistan
Author(s) -
Zaidi U.,
Borhany M.,
Ansari S.,
Parveen S.,
Boota S.,
Shamim I.,
Zahid D.,
Shamsi T.
Publication year - 2015
Publication title -
transfusion medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.471
H-Index - 59
eISSN - 1365-3148
pISSN - 0958-7578
DOI - 10.1111/tme.12196
Subject(s) - abo blood group system , medicine , thalassemia , antibody , red blood cell , blood transfusion , antigen , isoantibodies , immunology , red cell , logistic regression , beta thalassemia , gastroenterology
SUMMARY Background In Pakistan routine blood group typing of thalassemia patients identifies ABO and Rh(D) antigens only. Therefore, other antigen incompatibilities between blood donor and blood recipient may cause alloimmunisation. Objective The aim of this study was to estimate the frequency of alloimmunisation and to evaluate the risk factors associated with its development in beta (β)‐thalassemia patients receiving regular blood transfusions. Materials and Methods In total 162 β thalassemia patients were included in this study. An extended red cell antigen panel was performed to detect antibodies. Patients received red cell concentrates, which were matched for ABO and Rh(D) antigens. Clinical and laboratory data were collected and analysed to estimate the frequency of alloantibodies and the factors influencing immunisation in patients on regular blood transfusion. Results The median age of patients was 6·7 (range: 0·5–25) years. A total of 14 (8·6%) patients developed alloantibodies against red cell antigens. The most frequently occurring alloantibodies was anti‐E (2·5%), anti‐K (1·8%), anti‐e (1·2%) and anti‐D (0·6%). Five (3·1%) patients developed more than one red blood cell ( RBC ) alloantibody. Age at first transfusion in alloimmunised patients was 1·22 ± 0·87 years. The frequency of blood transfusion in alloimmunised patients was 23 ± 8·81 days and in those without alloimmunisation was 31·8 ± 16 days ( p = 0·02). Logistic regression analysis showed no independent risk factor associated with alloimmunisation. Conclusion The frequency of transfusion was increased in patients who developed alloantibodies. Typing patients and donors to match for Rh and Kell antigens would prevent more than 90% of RBC alloantibodies and reduce the frequency of transfusion in thalassemia patients.