Lifetime risk and characterization of red blood cell alloimmunization in chronically transfused patients with sickle cell disease
Journal Title: International Journal of Blood Transfusion and Immunohematology - Year 2015, Vol 5, Issue 1
Abstract
Aims: Patients with sickle cell disease (SCD) are often exposed to multiple units of blood transfusions predisposing them to the development of alloantibodies. Alloantibodies make subsequent transfusion difficult, costly and could also result in life-threatening hemolysis. The aim of this study is to estimate and characterize alloantibodies developing over a life-time in patients with sickle cell disease who are on chronic red cell transfusion. Methods: Retrospective data were obtained from the electronic medical record and sunquest transfusion record of the DMC for a total of 121 patients with SCD aged 18 years and older who were on chronic red cell exchange transfusion. Data on demographics, blood group, genotype, total number of units transfused over lifetime, presence and type of alloantibodies identified was collected and analyzed. Results: The median age of the studied patients was 33 years with a male to female ratio of 0.73. Almost all (>95%) patients had homozygous SCD. A total of 67,586 units were transfused for the 121 patients over a lifetime approximating an average of 559 units transfused per patient. Alloantibodies were identified in 68 of the 121 patients (56.2%). The most common antibody identified was E (27%) followed by K (23%) and C (12%). Overall, antibodies against the Rh system (E, C, D and e) accounted for 39% of the identified antibodies. Conclusion: These data demonstrate a high lifetime rate of alloimmunization for patients with SCD on chronic red cell exchange transfusion. Understanding the nature of alloantibody development in chronically transfused SCD patients can help foster appropriate blood utilization paradigms, and develop preventive strategies.
Authors and Affiliations
Indryas Woldie, P. Swerdlow, M. H. Bluth, U Mohammad
Keywords
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- EP ID EP209981
- DOI 10.5348/ijbti-2015-15-OA-1
- Views 94
- Downloads 0
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