Role of RBC's alloimmunization in multiple transfused thalassaemia patients

Amita Sagar Patel; Sejal Gamit; Mayuri Gohil

doi:10.18203/2320-6012.ijrms20160526

Authors

Amita Sagar Patel Department of Pathology, Govt. Medical College, Surat, Gujarat
Sejal Gamit Department of Pathology, Govt. Medical College, Surat, Gujarat
Mayuri Gohil Department of Pathology, Govt. Medical College, Bhavnagar, Gujarat

DOI:

https://doi.org/10.18203/2320-6012.ijrms20160526

Keywords:

Antibody screening, Thalassaemia, Red cell alloimmunization, Leucodepleted packed cells

Abstract

Background: Appropriate and regular red cell transfusion remains the main treatment of choice for a large number of patients with multiple transfusions. This study has been carried out to assess the prevalence of and to provide frequency and distribution patterns of various types of irregular red cell alloantibodies in thalassaemia major patients.

Methods: 50 patients of thalassemia major were studied. The saline method, Albumin method, indirect coombs’ and Three cell panel test used for detection of red blood cell alloantibody. The variables studied were rate of red cell alloimmunization, type and specificity of RBCs alloantibodies and factors contributes to development of RBCs alloimmunization like age, gender, age at start of transfusion, number of packed cell received and ethnicity.

Results: Out 50 patients of thalassemia major, 4 patients (8%) developed red cell alloantibodies respectively. The red cell alloantibodies were against Rh, Kidd, Kell, Duffy, Lewis, MNS and P system. Results of this study (P value >0.05) indicate low frequency of RBCs alloimmunization.

Conclusions: Low alloimmunization rate implies that there is homogeneity of red cell antigens in blood donors & recipients. RBCs alloantibody formation was not influenced by gender, age at start of transfusions and number of packed cells received. Already alloimmunized patients get benefits from leucodepleted packed cells. Specific recommendation given on routine pre-transfusion antibody screening to ensure safer transfusion.

Metrics

Metrics Loading ...

References

George E. Thalassaemia carrier diagnosis in Malaysia. Thalassaemia diagnosis services (ThalIDS). 1998.

Singer St, Wu V, Mignacca R, Kuypers FA, Morel P, Vichinsky E. Alloimmunization and erythrocyte autoimmunization in transfusion dependant thalassaemia patients of predominantly Asian descent.Blood. 2000;96:3369-73.

Spanos T, Karageorga M, Iadis V, Peristeri J, Hatziliami A, Kattamis C. Red cell alloantibodies in patients with thalassaemia.Vox sang. 1990;58:50-5.

Walker RH, Dong-tsamn Lin, Mary B. Arch pathol lab Med. 1989;113:254-60.

Brantly SG, Ramsey G. Red cell alloimmunization in multitransfused HLA-typed patients. Trasfusion. 1988;24:463-6.

Blumberg N, Ross K, Avila E, Peck K. Should chronic transfusion be matched for antigen other than ABO and Rh D Vox Sang. 1984;47:205-8.

Hoffbrand AV. Genetic disorder of haemoglobin. In post Graduate Haematology. Oxford University Press Inc, New York. 1999;91-119.

Spanos T, Karageorga M, I adis V, Peristeri J, Hatziliami A, Kattamis C. Red cell alloantibodies in patients with thalassaemia.Vox sang. 1994;58:50-5.

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;96:3369-73.

Castellino SM, Combs MR, Zimmerman SA, Issitt PD, Ware RE. Erythrocyte autoantibodies in paediatric patients with sickle cell disease receiving transfusion therapy: frequency, characteristics and significance. Br J Haematol. 1999;104:189-94.

Walker RH, Lin DT, Hartrick MB. Alloimmunization following blood transfusion. Arch Pathol Lab Med. 1989;113:254-61.

Pahuja S, Pujani M, Gupta SK, Chandra J, Jain M. Alloimmunization and red cell autoimmunization in multitransfused thalassemics of Indian origin. Hematology. 2010;15:174-7.

Chuansumrit A, Nathalang O, Wangruangsathit S. HLA alloimmunization in patients receiving multitransfusions of red blood cells. Southeast asian j trop med public health. 2001;32:419-24.

Ho HK, Ha SY, Lam CK, Chan GC. Alloimmunization in Hong Kong southern Chinese transfusion-dependent thalassemia patients. Blood. 2001;97:3999-4000.

Sirchia G, Zanella A, Parravicini A, Morelati F, Rebulla P, Masera G. Red cell alloantibodies in thalassemia major. Results of an Italian cooperative study. Transfusion. 1985;25:110-2.

Noor Haslina MN, Ariffin N, Illuni HI, Rosline H. Red cell autoantibodies among thalassaemia patients in Hospital Universiti Sains Malaysia. Singapore Med J. 2007;48:922-5.

Michail-Merianou V, Pamphili-Panousopoulou L, Piperi-Lowes L, Pelegrinis E, Karaklis A. Alloimmunization to red cell antigens in thalassemia: comparative study of usual versus better-match transfusion programmes. Vox Sang. 1987;52:95-8.

Fluit CR, Kunst VA, Drenthe-Schonk AM. Incidence of red cell antibodies after multiple blood transfusions. Transfusion. 1990;30:532-5.

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. Transfusion. 2003;43:1604-10.

Frabetti F, Musiani D, Marini M. White cell apoptosis in packed red cells. Transfusion. 1998;38:1082-9.

Pistillo MP, Tazzari PL, Gaudiano C, Cilla V, Kato T, Matsui T, et al. Patients with neoplastic and nonneoplastic hematological disease acquire CTLA-4 antibodies after blood transfusion. Transfusion. 2001;41:462-9.