Abstract
Introduction. Red blood cell (RBC) alloimmunization and autoimmunization remain a major problem in transfusion dependent thalassemic patients. There is a paucity of data on the incidence of RBC alloimmunization and autoimmunization in thalassemic patients from eastern part of India, as pretransfusion antibody screening is not routinely performed. Aims. To assess the incidence of RBC alloimmunization and autoimmunization in transfusion dependent thalassemic patients in eastern India. Materials and Methods. Total 500 thalassemia cases were evaluated. The antibody screening and identification were performed with commercially available panel cells (Diapanel, Bio-rad, Switzerland) by column agglutination method. To detect autoantibodies, autocontrol and direct antiglobulin tests were carried out using polyspecific coombs (IgG + C3d) gel cards in all patients. Results. A total of 28 patients developed RBC alloimmunization (5.6%) and 5 patients had autoantibodies (1%). Alloantibody against c had the highest incidence (28.57%) followed by E (21.42%). Five out of 28 (17.85%) patients had developed antibodies against both c and E. Conclusion. Data from this study demonstrate that the RBC alloantibody and autoantibody development rates are significant in our region. Thus, pretransfusion antibody screening needs to be initiated in eastern India in order to ensure safe transfusion practice.
Highlights
Red blood cell (RBC) alloimmunization and autoimmunization remain a major problem in transfusion dependent thalassemic patients
In the absence of stem cell transplantation, the disease is treated by life-long red blood cell (RBC) transfusion [2] to keep the hemoglobin (Hb) level between 9 and 11.5 g/dL
The term “clinically significant” in relation to alloantibodies may refer to an antibody that causes an obvious, clinical hemolytic transfusion reaction or an antibody that does not cause any overt clinical symptoms but Advances in Hematology is associated with laboratory signs of hemolysis or an antibody that is not associated with any clinical or laboratory signs of hemolysis, but RBCs incompatible with it survive less than normal lifespan [11]
Summary
Red blood cell (RBC) alloimmunization and autoimmunization remain a major problem in transfusion dependent thalassemic patients. There is a paucity of data on the incidence of RBC alloimmunization and autoimmunization in thalassemic patients from eastern part of India, as pretransfusion antibody screening is not routinely performed. To assess the incidence of RBC alloimmunization and autoimmunization in transfusion dependent thalassemic patients in eastern India. There is a paucity of data on the incidence of RBC alloimmunization and autoimmunization in thalassemic patients from this region, as pretransfusion antibody screening is not routinely performed. This study was conducted to find out the frequency of alloimmunization, autoimmunization, and most common alloantibodies involved to red cell antigens in thalassemic patients.
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