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Red blood cell alloimmunization in transfusion-dependent Egyptian patients with thalassemia in a limited donor exposure program.
MedLine Citation:
PMID:  21745214     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Thalassemia is considered the most common hemoglobinopathy in Egypt and is one of its major health problems. Lifelong red blood cell (RBC) transfusion remains the main treatment for severe forms; however, RBC alloimmunization results as a complication of regular transfusions due to repeated exposure to foreign antigens. The objective was to compare the frequency of alloantibodies in a group of patients in a limited donor exposure program (LDEP) with those receiving RBCs from multiple donors in Egyptian transfusion-dependent patients with thalassemia. STUDY DESIGN AND METHODS: A total of 235 regularly transfused patients with thalassemia were studied, 36 of which were on LDEP. All patients were investigated for the presence of RBC autoantibodies and alloantibodies, followed by antibody identification for positive patients. RESULTS: Forty-six (19.5%) patients developed RBC alloantibodies. The most common clinically significant alloantibodies were directed against antigens in the Kell and Rh systems. Development of alloantibodies was associated with older age, higher transfusion frequency, and splenectomy. A trend toward lower alloimmunization was elicited in the LDEP group, where 8.3% (3/36) patients were alloimmunized compared to 21.6% (43/199) in the non-LDEP one (p = 0.057). CONCLUSIONS: Examination of donor RBCs for presence of Kell and Rh(E) antigens before transfusion can help decrease RBC alloimmunization. Further larger studies are required to assess the frequency of alloantibody production in patients on LDEP.
Authors:
Azza S El Danasoury; Doaa G Eissa; Reham M Abdo; Mohsen S Elalfy
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-11
Journal Detail:
Title:  Transfusion     Volume:  -     ISSN:  1537-2995     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-7-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 American Association of Blood Banks.
Affiliation:
From the Department of Clinical Pathology and the Department of Pediatrics, Ain Shams University, Cairo, Egypt.
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