Alloimmunization in transfused patients with constitutional anemias in Norway |
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| Affiliation: | 1. Department of Immunology and Transfusion Medicine, Oslo University Hospital, Ullevaal, Oslo, Norway;2. Department of Life Sciences and Health, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway;3. Department of Pediatric Hematology and Oncology, Oslo University Hospital, Oslo, Norway;1. Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, TX, United States;2. Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States;3. Department of Laboratory Medicine, Section of Transfusion Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX, United States;4. Section of Benign Hematology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States;1. Center for Cell-Based Research, Regional Blood Center of Ribeirão Preto, School of Medicine of Ribeirão Preto, São Paulo, Brazil;2. University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil;3. Department of Clinical Medicine, School of Medicine of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil;4. Laboratório de Imunohematologia Molecular do Hemocentro – Unicamp, Campinas, SP, Brazil;5. Département Centre National de Référence pour les Groupes Sanguins, Institut National de la Transfusion Sanguine (INTS), Paris, France;1. Blood Transfusion Centre, Legnano General Hospital, ASST Ovest Milanese, Legnano, Italy;2. Pharmacy Service Unit, ASST Ovest Milanese, Legnano General Hospital, Legnano, Italy |
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| Abstract: | ![]()
Background and ObjectivesThe status of red blood cell alloimmunization in patients with constitutional anemias including hemoglobinopathies is not known in Norway. The study objective was to investigate the impact of a strategy based on phenotype-matching for C, c, E, e, K, Jka, Jkb, Fya, Fyb, S and s on alloimmunization.Materials and MethodsWe reviewed transfusions of 40 patients retrospectively using the computerized blood bank management system and medical records; including diagnosis, age at start of transfusion therapy, gender, number and age of packed red blood cell units transfused, follow-up time, phenotypes of the donors and patients, antigen-negative patients exposed to antigen-positive packed red blood cell units, transfusion reactions and alloantibody specificities.ResultsForty patients received 5402 packed red blood cell units. Alloimmunization frequency was 20 % for the whole group, being 7%, 25 % and 30 % in patients with sickle cell disease (n = 14), thalassemia (n = 16) and other conditions (n = 10), respectively. The alloantibodies detected were anti-E, -c, -C, -Cw, -K, -Jka and -Lua.ConclusionGood communication between the clinicians and the transfusion services is essential for successful management of patients with constitutional anemias. Providing full phenotype-matched units was not always possible. Extended pheno-/genotyping before the first transfusion and providing antigen-negative units for antigen-negative patients for at least C, c, E and K in every red cell transfusion would probably have reduced the alloimmunization rate. Non-phenotype-matched transfusions seem to be the main reason for alloimmunization. Finding markers for identifying responders prone to alloimmunization will ensure targeted transfusion strategies. |
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| Keywords: | Alloimmunization Thalassemia Sickle cell disease Blood transfusion |
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