Analysis of risk factors for red blood cell alloimmunization and its incidence in hemoglobinopathy patients at a tertiary care center in Odisha, Eastern India

Abstract

Abstract BACKGROUND: Sickle cell disease (SCD) and thalassemia are common hemoglobinopathies in Eastern India. Regular blood transfusion in these patients leads to alloimmunization. Finding compatible red blood cell units remain a challenge in these patients delaying the transfusion support. AIMS: This study aims to estimate the frequency of alloimmunization and predicts the associated risk factors. METHODOLOGY: A retrospective study was conducted for 2 years. Data were retrieved from the immunohematology work-up record. The Chi-square statistics determined the risk factors associated with alloimmunization. Multivariate regression analysis was used to identify independent risk factors of alloimmunization, adjusting the confounders. A P < 0.05 was considered as statistically significant. RESULTS: Forty-seven patients out of 132 developed antibodies. Of these, 41 presented with only alloantibodies, three patients had only autoantibodies, and the rest 3 had both autoantibodies and alloantibodies. Most commonly observed alloantibodies were against Rh, Kidd, Duffy, and S antigens. SCD appeared a significant risk factor for the development of alloimmunization in the Chi-square test (P = 0.003). However, multivariate analysis revealed only age of more than 2 years at the first transfusion, and up to ten transfusions are independent risk factors of alloimmunization (P < 0.05). CONCLUSION: We found a high incidence of alloimmunization in multitransfused hemoglobinopathies patients in this region. This study also shows the first transfusion at an age of more than 2 years and up to 10 transfusions are independent predictors of alloimmunization.