Red Blood Cell Alloimmunisation in Transfusion-dependent Thalassaemia: a Systematic Review

Overview

Journal Blood Transfus

Specialty Hematology

Date 2019 Jan 18

PMID 30653458

Citations 13

Authors

Massimo Franchini

Gian Luca Forni

Giuseppe Marano

Mario Cruciani

Carlo Mengoli

Valeria Pinto

Lucia De Franceschi

Donatella Venturelli

Maddalena Casale

Martina Amerini

Martina Capuzzo

Giuliano Grazzini

Francesca Masiello

Ilaria Pati

Eva Veropalumbo

Stefania Vaglio

Simonetta Pupella

Giancarlo M Liumbruno

Affiliations

Soon will be listed here.

Abstract

Background: Chronic red blood cell transfusion is the first-line treatment for severe forms of thalassaemia. This therapy is, however, hampered by a number of adverse effects, including red blood cell alloimmunisation. The aim of this systematic review was to collect the current literature data on erythrocyte alloimmunisation.

Materials And Methods: We performed a systematic search of the literature which identified 41 cohort studies involving 9,256 patients.

Results: The prevalence of erythrocyte alloimmunisation was 11.4% (95% CI: 9.3-13.9%) with a higher rate of alloimmunisation against antigens of the Rh (52.4%) and Kell (25.6%) systems. Overall, alloantibodies against antigens belonging to the Rh and Kell systems accounted for 78% of the cases. A higher prevalence of red blood cell alloimmunisation was found in patients with thalassaemia intermedia compared to that among patients with thalassaemia major (15.5 vs 12.8%).

Discussion: Matching transfusion-dependent thalassaemia patients and red blood cell units for Rh and Kell antigens should be able to reduce the risk of red blood cell alloimmunisation by about 80%.

Citing Articles

Red cell specifications for blood group matching in patients with haemoglobinopathies: An updated systematic review and clinical practice guideline from the International Collaboration for Transfusion Medicine Guidelines.

Wolf J, Blais-Normandin I, Bathla A, Keshavarz H, Chou S, Al-Riyami A Br J Haematol. 2024; 206(1):94-108.

PMID: 39535318 PMC: 11739758. DOI: 10.1111/bjh.19837.

Characterization of pediatric transfusion-dependent thalassemia patients in a large academic center.

Zarrabian D, Hanna M J Clin Lab Anal. 2023; 37(17-18):e24962.

PMID: 37665129 PMC: 10623514. DOI: 10.1002/jcla.24962.

Transfusion in hemoglobinopathies and red blood cell alloimmunization: data from Sicily, Sardinia and Malta.

Garozzo G, Messina R, Manca P, Aquilina A Blood Transfus. 2023; 22(2):111-121.

PMID: 37235738 PMC: 10920071. DOI: 10.2450/BloodTransfus.465.

Prevalence and specificity of red blood cell alloantibodies and autoantibodies in transfused Iranian β-thalassemia patients: A systematic review and meta-analysis.

Rostamian H, Javandoost E, Mohammadian M, Alipour A Asian J Transfus Sci. 2022; 16(1):111-120.

PMID: 36199396 PMC: 9528548. DOI: 10.4103/ajts.AJTS_39_20.

Red blood cell alloimmunization and other transfusion-related complications in patients with transfusion-dependent thalassemia: A multi-center study in Thailand.

Teawtrakul N, Songdej D, Hantaweepant C, Tantiworawit A, Lauhasurayotin S, Torcharus K Transfusion. 2022; 62(10):2039-2047.

PMID: 35986658 PMC: 9560980. DOI: 10.1111/trf.17068.

References

Vaziri M, JavadzadehShahshahani H, Moghaddam M, Taghvaee N . Prevalence and specificities of red cell alloantibodies in transfusion-dependent beta thalassemia patients in Yazd. Iran J Ped Hematol Oncol. 2015; 5(2):93-9. PMC: 4475630. View

Sadeghian M, Keramati M, Badiei Z, Ravarian M, Ayatollahi H, Rafatpanah H . Alloimmunization among transfusion-dependent thalassemia patients. Asian J Transfus Sci. 2010; 3(2):95-8. PMC: 2920480. DOI: 10.4103/0973-6247.53884. View

Moeen S, Farooq N, Irshad R, Ashfaq M, Farooq U, Idris M . Red Cell Alloimmunization In Multitransfused Thalassaemia Major Patients. J Ayub Med Coll Abbottabad. 2018; 30(1):81-84. View

Trinchero A, Marchetti M, Giaccherini C, Tartari C, Russo L, Falanga A . Platelet haemostatic properties in β-thalassaemia: the effect of blood transfusion. Blood Transfus. 2016; 15(5):413-421. PMC: 5589704. DOI: 10.2450/2016.0033-16. View

Abdelrazik A, ELshafie S, Said M, Ezzat Ahmed G, Al-Gamil A, El Nahhas M . Study of red blood cell alloimmunization risk factors in multiply transfused thalassemia patients: role in improving thalassemia transfusion practice in Fayoum, Egypt. Transfusion. 2016; 56(9):2303-7. DOI: 10.1111/trf.13695. View

Thompson A, Cunningham M, Singer S, Neufeld E, Vichinsky E, Yamashita R . Red cell alloimmunization in a diverse population of transfused patients with thalassaemia. Br J Haematol. 2011; 153(1):121-8. PMC: 5728106. DOI: 10.1111/j.1365-2141.2011.08576.x. View

Seferi I, Xhetani M, Face M, Burazeri G, Nastas E, Vyshka G . Frequency and specificity of red cell antibodies in thalassemia patients in Albania. Int J Lab Hematol. 2015; 37(4):569-74. DOI: 10.1111/ijlh.12362. View

Ahmed A, Hasan N, Ragab S, Habib S, Emara N, Aly A . Red cell alloimmunization and autoantibodies in Egyptian transfusion-dependent thalassaemia patients. Arch Med Sci. 2012; 6(4):592-8. PMC: 3284076. DOI: 10.5114/aoms.2010.14473. View

Velati C, Romano L, Piccinini V, Marano G, Catalano L, Pupella S . Prevalence, incidence and residual risk of transfusion-transmitted hepatitis C virus and human immunodeficiency virus after the implementation of nucleic acid testing in Italy: a 7-year (2009-2015) survey. Blood Transfus. 2018; 16(5):422-432. PMC: 6125236. DOI: 10.2450/2018.0069-18. View

10.

Vichinsky E, Neumayr L, Trimble S, Giardina P, Cohen A, Coates T . Transfusion complications in thalassemia patients: a report from the Centers for Disease Control and Prevention (CME). Transfusion. 2013; 54(4):972-81. PMC: 4410835. DOI: 10.1111/trf.12348. View

11.

Zaidi U, Borhany M, Ansari S, Parveen S, Boota S, Shamim I . Red cell alloimmunisation in regularly transfused beta thalassemia patients in Pakistan. Transfus Med. 2015; 25(2):106-10. DOI: 10.1111/tme.12196. View

12.

Gupta R, Singh D, Singh B, Rusia U . Alloimmunization to red cells in thalassemics: emerging problem and future strategies. Transfus Apher Sci. 2011; 45(2):167-70. DOI: 10.1016/j.transci.2011.07.014. View

13.

Compernolle V, Chou S, Tanael S, Savage W, Howard J, Josephson C . Red blood cell specifications for patients with hemoglobinopathies: a systematic review and guideline. Transfusion. 2018; 58(6):1555-1566. DOI: 10.1111/trf.14611. View

14.

Chou S, Liem R, Thompson A . Challenges of alloimmunization in patients with haemoglobinopathies. Br J Haematol. 2012; 159(4):394-404. DOI: 10.1111/bjh.12061. View

15.

Mehrzad V, Sajjadieh Khajouei A, Fahami E . Correlation of N-terminal pro-B-type natriuretic peptide levels and cardiac magnetic resonance imaging T2* in patients with β-thalassaemia major. Blood Transfus. 2016; 14(6):516-520. PMC: 5111375. DOI: 10.2450/2016.0120-15. View

16.

el-Danasoury A, Eissa D, Abdo R, Elalfy M . Red blood cell alloimmunization in transfusion-dependent Egyptian patients with thalassemia in a limited donor exposure program. Transfusion. 2011; 52(1):43-7. DOI: 10.1111/j.1537-2995.2011.03234.x. View

17.

Al-Riyami A, Al-Mahrooqi S, Al-Hinai S, Al-Hosni S, Al-Madhani A, Daar S . Transfusion therapy and alloimmunization in Thalassemia Intermedia: a 10 year experience at a tertiary care university hospital. Transfus Apher Sci. 2014; 51(1):42-6. DOI: 10.1016/j.transci.2014.04.009. View

18.

Al-Riyami A, Al-Muqbali A, Al-Sudiri S, Panchatcharam S, Zacharia M, Al-Mahrooqi S . Risks of red blood cell alloimmunization in transfusion-dependent β-thalassemia in Oman: a 25-year experience of a university tertiary care reference center and a literature review. Transfusion. 2018; 58(4):871-878. DOI: 10.1111/trf.14508. View

19.

Musso D, Aubry M, Broult J, Stassinopoulos A, Green J . Zika virus: new emergencies, potential for severe complications, and prevention of transfusion-transmitted Zika fever in the context of co-circulation of arboviruses. Blood Transfus. 2016; 15(3):272-273. PMC: 5448835. DOI: 10.2450/2016.0003-16. View

20.

Chao Y, Wu K, Lu J, Shih M, Peng C, Chang C . Red blood cell alloimmunisation among Chinese patients with β-thalassaemia major in Taiwan. Blood Transfus. 2012; 11(1):71-4. PMC: 3557491. DOI: 10.2450/2012.0153-11. View