Red cell alloimmunization in repeatedly transfused children with beta thalassemia major

Abstract

Background: The development of anti-red blood cell alloantibodies remains a major problem in thalassemia major patients. We studied the frequency of red blood cell (RBC) allo-immunization among Beta thalassemia major patients who received regular transfusions at our center and analyzed the factors, which may be responsible for development of these antibodies.Methods:An observational study was conducted in department of Pediatric Medicine, SMS Medical College, Jaipur. A total of 150 patients of Beta Thalassemia major who already received multiple transfusions were randomly selected and screening of Red Cell Alloantibodies was done by using SPRCA (solid phase red cell adhesion) method during May 2015 to April 2016. Statistical analysis was done using computer software (SPSS version 20 and primer). The qualitative data were expressed in proportion and percentages and the quantitative data expressed as mean and standard deviations. The difference in proportion was analysed by using chi-square test and the difference in means were analysed by using student t- Test. Significance level for tests were determined as 95% (P <0.05).Results: Total 150 cases were included. Male female ratio was 1.63:1, 10 cases (6.67%) were positive for alloantibodies. Among these 10 positive cases, 2 had positive family history and 3 had history of splenectomy. In allo-immunised cases mean age, mean age at first transfusion and total number of transfusions were significantly higher in comparison to non-allo-immunized cases.Conclusions:If patient has red cell alloantibody on regular interval screening then the antibody identification should be performed and corresponding antigen negative blood transfusion is strongly recommended in transfusion dependent thalassemia patients.