RBC alloimmunization and autoimmunization among transfusion‐dependent Arab thalassemia patients
- 24 October 2003
- journal article
- research article
- Published by Wiley in Transfusion
- Vol. 43 (11), 1604-1610
- https://doi.org/10.1046/j.1537-2995.2003.00549.x
Abstract
BACKGROUND: Thalassemia major is a common hemoglobinopathy in the Arabian Gulf region. However, limited data are available on the frequency of RBC alloimmunization and autoimmunization in transfusion-dependent Arab thalassemia patients. STUDY DESIGN AND METHODS: A total of 190 thalassemia major patients were classified as Kuwaiti Arab and non-Kuwaiti Arab. Pretransfusion investigation records were reviewed for the presence of RBC alloantibody and autoantibody, and the age at which RBC alloantibody was developed. RESULTS: Fifty-seven (30%) patients developed RBC alloantibodies. The most common clinically significant alloantibodies were directed against antigens in the Kell and Rh systems. Anti-K developed in 41 (72%) patients followed by anti-E in 26 (45.6%). RBC autoantibodies developed in 21 (11%) patients with and without underlying RBC alloantibodies. Sixty-six (49.6%) RBC alloantibodies developed between the ages of 2 and 10 years. CONCLUSION: Several factors might have contributed to the high alloimmunization and autoimmunization rate observed in this study, including the heterogeneity of the population living in Kuwait, lack of better-matched donors for those patients, and the use of poststorage leukodepleted blood. It is recommended that thalassemia patients receive blood matched for Rh and Kell antigens and prestorage leukodepleted RBCs.Keywords
This publication has 28 references indexed in Scilit:
- Nuclear matrix protein is released from apoptotic white cells during cold (1‐6°C) storage of concentrated red cell units and might induce antibody response in multiply transfused patientsTransfusion, 2000
- CD80 (B7-1) Binds Both CD28 and CTLA-4 with a Low Affinity and Very Fast KineticsThe Journal of Experimental Medicine, 1997
- The Molecular Basis for Phenotypic Diversity of Genetic DiseaseAnnals of the New York Academy of Sciences, 1995
- Molecular Characterization of α-Thalassemia Determinants, β-Thalassemia Alleles, and βs Haplotypes among Kuwaiti ArabsActa Haematologica, 1994
- The differentiation of delayed serologic and delayed hemolytic transfusion reactions: incidence, long‐term serologic findings, and clinical significanceTransfusion, 1990
- Incidence of red cell antibodies after multiple blood transfusionTransfusion, 1990
- Problems in Transfusion TherapyNew England Journal of Medicine, 1990
- High-Dose Intravenous Immunoglobulin in the Management of Autoimmune Hemolytic Anemia Complicating Thalassemia majorActa Haematologica, 1990
- An Association between Thalassaemia and Autoimmune Haemolytic Anaemia (AIHA)Scandinavian Journal of Haematology, 1981
- Frequency of Antibodies to Various Antigenic Determinants in Polytransfused Patients with Homozygous Thalassaemia in GreeceVox Sanguinis, 1971