Correlation between blood group and autoantibodies formation in multi-transfused thalassaemia patients
DOI:
https://doi.org/10.18203/2320-6012.ijrms20242923Keywords:
Alloimmunization, Autoantibodies, Blood transfusion, Blood group, ThalassemiaAbstract
Background: Thalassemia is a prevalent genetic disorder of hemoglobin synthesis, characterized by reduced production or absence of one or more globin chains, requiring frequent blood transfusions that can lead to complications such as autoantibody formation. The purpose of this study was to assess the correlation between blood group and the formation of autoantibodies in thalassemia patients who have received multiple blood transfusions.
Methods: This cross-sectional study at the Department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, conducted from October 2017 to September 2018, included 384 thalassemia patients who received at least 10 units of red cell concentrate. Participants were selected based on specific inclusion and exclusion criteria, with informed consent obtained. Data collection involved patient interviews, clinical examinations, and hematological tests. Statistical analysis using SPSS version 23.0 included Chi-square, Fisher’s exact, and t-tests, with significance set at p<0.05.
Results: Among 384 patients, the most common blood group was B+ (46.2%). Coombs' test results showed DCT positivity in 3.1% of 384 patients, ICT positivity in 7.5%, and both DCT and ICT in 4.2%. Most patients (92.3%) had their first transfusion after age 2, with 84.6% receiving transfusions every 2-4 weeks.
Conclusions: In conclusion, B positive blood group thalassemia patients receiving frequent transfusions are at a higher risk of autoantibody formation, and Rhesus phenotype-matched blood with pre-storage leukodepletion is recommended to mitigate this risk.
References
Weatherall DJ, Clegg JB. The thalassaemia syndromes. Blackwell science 4th ed. Oxford; 2001.
Weatherall DJ, Clegg JB. Historical perspectives: the many and diverse routes to our current understanding of the thalassaemia syndromes. In: The Thalassaemia Syndromes. Oxford; 2001:3-64.
Weatherall D, Akinyanju O, Fucharoen S, Olivieri N, Jamison DT, Breman JG, et al. Musgrove PInherited disorders of hemoglobin. In: Disease control priorities in developing countries. Washington (DC): World Bank; 2006:663-80.
Cooley TB, Lee OP. Series of cases of splenomegaly in children with anemia and peculiar bone changes. Trans Amer Pediatr Soc. 1925;37:29-30.
Rietti F. Sugli itteri emolitici primitivi. Atti Accad Sci Med Natl Ferrara. 1925;2:14-22.
Weatherall DJ. Thalassemia as a global health problem: recent progress toward its control in the developing countries. Ann New York Acad Sci. 2010;1202(1):17-23.
Angastiniotis M, Lobitz S. Thalassemias: An overview. Int J Neonatal Screen. 2019;5(1):16.
Weatherall DJ, Clegg JB. Historical perspectives: the many and diverse routes to our current understanding of the thalassaemia syndromes. In: The Thalassaemia Syndrome. New York, Oxford: Blackwell Science Ltd; 2001:63-4.
Ameen R, Al-Shemmari S, Al-Humood S, Chowdhury RI, Al-Eyaadi O, Al-Bashir A. RBC alloimmunization and autoimmunization among transfusion-dependent Arab thalassemia patients: alloimmunization among Arab thalassemia patients. Transfusion. 2003;43(11):1604-10.
Singer ST, Wu V, Mignacca R, Kuypers FA, Morel P, Vichinsky EP. Alloimmunization and erythrocyte autoimmunization in transfusion-dependent thalassemia patients of predominantly Asian descent. Blood. 2000;96(10):3369-73.
Kruatrachue M, Sirisinha S, Pacharee P, Chandarayingyong D, Wasi P. An association between thalassaemia and autoimmune haemolytic anaemia (AIHA). Scandi J Haematol. 1981;25(3):259-63.
Ho HK, Ha SY, Lam CK, Chan GC, Lee TL, Chiang AK, et al. Alloimmunization in Hong Kong southern Chinese transfusion-dependent thalassemia patients. Blood. 2001;97(12):3999-4000.
Argiolu F, Diana G, Arnone M, Batzella MG, Piras P, Cao A. High-dose intravenous immunoglobulin in the management of autoimmune hemolytic anemia complicating thalassemia major. Acta Haematol. 1990;83(2):65-8.
Cianciulli P, Sorrentino F, Morino L, Massa A, Sergiacomi GL, Donato V, et al. Radiotherapy combined with erythropoietin for the treatment of extramedullary hematopoiesis in an alloimmunized patient with thalassemia intermedia. Ann Hematol. 1996;72:379-81.
Musallam KM, Lombard L, Kistler KD, Arregui M, Gilroy KS, Chamberlain C, Zagadailov E, Ruiz K, Taher AT. Epidemiology of clinically significant forms of alpha‐and beta‐thalassemia: A global map of evidence and gaps. Am J Hematol. 2023;98(9):1436-51.
Pazgal I, Yahalom V, Shalev B, Raanani P, Stark P. Alloimmunization and autoimmunization in adult transfusion-dependent thalassemia patients: a report from a comprehensive center in Israel. Ann Hematol. 2020;99:2731-6.
Waldis SJ, Uter S, Kavitsky D, Flickinger C, Vege S, Friedman DF, et al. Rh alloimmunization in chronically transfused patients with thalassemia receiving RhD, C, E, and K matched transfusions. Blood Advan. 2021;5(3):737-44.
