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CC BY-NC-ND 4.0 · Journal of Health and Allied Sciences NU 2015; 05(03): 004-008
DOI: 10.1055/s-0040-1703903
Original Article

Red blood cell alloimmunisation and autoimmunisation in transfusion dependent beta thalassemics from Southern India

Mohammed Saleem E. K.
1   Senior Resident, Department of Pediatrics, MES Academy of Medical Sciences, Kerala University of Health Sciences, Kerala
,
Soundarya Mahalingam
2   Associate Professor, Department of Pediatrics, KMC, Mangalore, Manipal University, Manipal
,
Shamee Shastri
3   Associate Professor, Department of Immunohematology and Blood transfusion, KMC, Manipal University, Manipal
,
Kamalakshi G. Bhat
4   Professor Department of Pediatrics, KMC, Mangalore, Manipal University, Manipal
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Abstract

The development of red blood cell (RBC) isoimmunization with alloantibodies and autoantibodies complicate transfusion therapy in multiply transfused thalassemia patients. We conducted a study to analyse the frequency in our population. Clinical and antibody profile from 55 multiply transfused thalassemic patients who were receiving transfusions were collected and analyzed prospectively. A commercially available 3 cell antigen panel was used for the antibody screening procedure. If antibody screening with the 3-cell antigen panel was positive, an extended 11-cell antigen panel was used for antibody identification in LISS (Low Ionic Strength Solution). All patients received blood matched for only ABO and Rh (D) antigens. A total of 55 transfusion dependent â thalassemics were included in this study out of which 30 (54.55%) were males and 25(45.45%) females with a male to female ratio of 1.2: 1. Frequency of red cell alloimmunization in this study was found to be 1.8%. None of the patients developed red cell autoimmunization. The alloantibody identified in the the patient who developed alloimmunisation was was anti-K. In conclusion, the transfusion of matched blood is essential for chronically transfused beta thalassemia patients in order to avoid alloimmunization.

Keywords

alloimmunisation - beta thalassemia major - transfusion


Publication History

Article published online:
22 April 2020

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  • References

  • 1 Singer ST, Wu V, Mignacca R, Kuypers FA, Morel P, Vichinsky EP. Alloimmunization and erythrocyte autoimmunization in transfusiondependent thalassemia patients of predominantly Asian descent. Blood 2000; 96: 3369-3373.
  • 2 Pahuja S, Pujani M, Gupta G K, Chandra J and Jain M. Alloimmunization and red cell autoimmunization in multitransfused thalassemics of Indian origin. Hematology 2010; vol 15; 3; 174-177.
  • 3 Jolly JG, Agnihothri SK, Choudhury N, Gupta D. Evaluation of hemotherapy in thalassemias. Journal of Indian Med Assoc 1992; 90: 7-9.
  • 4 Surg CDR CN Chaudhari. Red Cell Alloantibodies in Multiple Transfused Thalassaemia Patients. MJAFI 2011; 67 : 34-37
  • 5 Wang LY, Liang DC, Liu HC, Chang FC, Wang CL, Chan YS, Lin M. Alloimmunization among patients with transfusion-dependent thalassemia in Thaiwan. Transfus Med. 2006 Jun; 16(3):200-3.
  • 6 Kruatrachu M, Sirisinha S, Pacharee P, Chandarayingyong D. An association between thalassemia and autoimmune haemolytic anemia (AIHA). Scand J Haematol. 1980;25:259-263.
  • 7 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 Haemaol 1990,83:65-68.
  • 8 P. Cianciulli, F. Sorrentino, L. Morino, A. Massa, G. L. Sergiacomi, V. Donato, S. Amadori. Radiotherapy combined with erythropoietin for the treatment of extramedullary hematopoiesis in an alloimmunized patient with thalassemia intermedia. Ann Hematol. 1996;73:379-381.
  • 9 Spanos T, Karageorga M, Ladis V, Peristeri J, Hatziliami A, Kattamis C. Red cell alloantibodies in patients with thalassemia. Vox Sang. 1990;58:50-55.
  • 10 Coles SM, Klein HG, Holland PV. Alloimmunization in two multitransfused patient populations. Transfusion 1981;21:462–466.
  • 11 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
  • 12 Michail-Merianou V, Pamphili-Panousopaulou 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;52:95-98.
  • 13 Ameen R, Al-Shemmari S, Al-Humood S, Chowdhury RI, Al-Eyaadi O, Al- Bashir A. RBC alloimmunization and auto immunization among transfusion-dependent Arab thalassemia patients. Transfusion 2003; 43: 1604-1610.
  • 14 Karimi M, Nikrooz P, Kashef S, Jamalian N,Davatolhagh Z. RBC alloimmunization in blood transfusion-dependent beta-thalassemia patients in southern Iran. Int J Lab Hematol. 2007 Oct;29(5):321-6.
  • 15 Noor Haslina MN, Ariffin N, Illuni Hayati I, Rosline H. Red cell immunization in multiply transfused Malay thalassemic patients. Southeast Asian J Trop Med Public Health. 2006 Sep;37(5):1015-20.
  • 16 Bilwani F, Kakepoto GN, Adil SN, Usman M, Hassan F, Kurshid M. Frequency of irregular red cell alloantibodies in patients with thalassemia major: a bicenter study. J Pak Med Assoc. 2005;55(12):563-5.
  • 17 Bhatti FA, Salamat N, Nadeem A, Shabbir N. Red cell immunization in beta Thalassemia major. J Coll Physicians Surg Pak. 2004;14(11):657-60.
  • 18 WF Rosse, D Gallagher, TR Kinney, O Castro, H Dosik, J Moohr, W Wang and PS Levy. Transfusion and Alloimmunization in Sickle cell disease. Blood. 1990; 76 : 1431-1437