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Alloimmunization in Patients with Sickle Cell Disease and Thalassemia: Experience of a Single Centre in Oman

BACKGROUND: Blood transfusion is an integral part of the supportive care for patients with sickle cell disease (SCD) and thalassaemia. The hazard of red cell alloimmunization, however, is one of the main complications of this therapy. OBJECTIVES: The aim of this study was to evaluate the prevalence...

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Autores principales: Alkindi, Salam, AlMahrooqi, Saba, AlHinai, Sumaiya, AlMarhoobi, Ali, Al-Hosni, Saif, Daar, Shahina, Fawaz, Naglaa, Pathare, Anil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Università Cattolica del Sacro Cuore 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5333756/
https://www.ncbi.nlm.nih.gov/pubmed/28293401
http://dx.doi.org/10.4084/MJHID.2017.013
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author Alkindi, Salam
AlMahrooqi, Saba
AlHinai, Sumaiya
AlMarhoobi, Ali
Al-Hosni, Saif
Daar, Shahina
Fawaz, Naglaa
Pathare, Anil
author_facet Alkindi, Salam
AlMahrooqi, Saba
AlHinai, Sumaiya
AlMarhoobi, Ali
Al-Hosni, Saif
Daar, Shahina
Fawaz, Naglaa
Pathare, Anil
author_sort Alkindi, Salam
collection PubMed
description BACKGROUND: Blood transfusion is an integral part of the supportive care for patients with sickle cell disease (SCD) and thalassaemia. The hazard of red cell alloimmunization, however, is one of the main complications of this therapy. OBJECTIVES: The aim of this study was to evaluate the prevalence of red cell alloimmunization in Omani patients with sickle cell anaemia and thalassemia. METHODS: This study included 262 patients whose historical transfusion records were available. One hundred and twenty-nine patients with thalassaemia who were attending the day care unit for regular transfusions, and 133 SCD patients admitted at our hospital were included in this study. The Diamed® gel system was used for the screening and identification of atypical antibodies. RESULTS: The rate of alloimmunization in SCD patients was 31.6% (n=42, 95%CI, 24.87–40.66), whereas in patients with thalassaemia it was 20% (n=26; 95%CI, 13.9–27.6). Antibodies to E, e, C, c, D, K, S, Fyª, Kpª, Jkª and C(w) were observed; 85% of the patients were also immunised with Rh and Kell antigens. Considering the two groups together, 8 developed nonspecific antibodies and 12 developed more than one antibody. CONCLUSIONS: Red cell transfusions were associated with a significant risk of alloimmunization. It is, therefore, imperative to perform an initial extended red cell phenotyping for both donors and recipients, and carefully select ABO, Rh and Kell matched donors. The higher incidence of alloimmunization in SCD patients is related to the inherent SCD-specific inflammatory state.
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spelling pubmed-53337562017-03-14 Alloimmunization in Patients with Sickle Cell Disease and Thalassemia: Experience of a Single Centre in Oman Alkindi, Salam AlMahrooqi, Saba AlHinai, Sumaiya AlMarhoobi, Ali Al-Hosni, Saif Daar, Shahina Fawaz, Naglaa Pathare, Anil Mediterr J Hematol Infect Dis Original Article BACKGROUND: Blood transfusion is an integral part of the supportive care for patients with sickle cell disease (SCD) and thalassaemia. The hazard of red cell alloimmunization, however, is one of the main complications of this therapy. OBJECTIVES: The aim of this study was to evaluate the prevalence of red cell alloimmunization in Omani patients with sickle cell anaemia and thalassemia. METHODS: This study included 262 patients whose historical transfusion records were available. One hundred and twenty-nine patients with thalassaemia who were attending the day care unit for regular transfusions, and 133 SCD patients admitted at our hospital were included in this study. The Diamed® gel system was used for the screening and identification of atypical antibodies. RESULTS: The rate of alloimmunization in SCD patients was 31.6% (n=42, 95%CI, 24.87–40.66), whereas in patients with thalassaemia it was 20% (n=26; 95%CI, 13.9–27.6). Antibodies to E, e, C, c, D, K, S, Fyª, Kpª, Jkª and C(w) were observed; 85% of the patients were also immunised with Rh and Kell antigens. Considering the two groups together, 8 developed nonspecific antibodies and 12 developed more than one antibody. CONCLUSIONS: Red cell transfusions were associated with a significant risk of alloimmunization. It is, therefore, imperative to perform an initial extended red cell phenotyping for both donors and recipients, and carefully select ABO, Rh and Kell matched donors. The higher incidence of alloimmunization in SCD patients is related to the inherent SCD-specific inflammatory state. Università Cattolica del Sacro Cuore 2017-02-15 /pmc/articles/PMC5333756/ /pubmed/28293401 http://dx.doi.org/10.4084/MJHID.2017.013 Text en This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Alkindi, Salam
AlMahrooqi, Saba
AlHinai, Sumaiya
AlMarhoobi, Ali
Al-Hosni, Saif
Daar, Shahina
Fawaz, Naglaa
Pathare, Anil
Alloimmunization in Patients with Sickle Cell Disease and Thalassemia: Experience of a Single Centre in Oman
title Alloimmunization in Patients with Sickle Cell Disease and Thalassemia: Experience of a Single Centre in Oman
title_full Alloimmunization in Patients with Sickle Cell Disease and Thalassemia: Experience of a Single Centre in Oman
title_fullStr Alloimmunization in Patients with Sickle Cell Disease and Thalassemia: Experience of a Single Centre in Oman
title_full_unstemmed Alloimmunization in Patients with Sickle Cell Disease and Thalassemia: Experience of a Single Centre in Oman
title_short Alloimmunization in Patients with Sickle Cell Disease and Thalassemia: Experience of a Single Centre in Oman
title_sort alloimmunization in patients with sickle cell disease and thalassemia: experience of a single centre in oman
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5333756/
https://www.ncbi.nlm.nih.gov/pubmed/28293401
http://dx.doi.org/10.4084/MJHID.2017.013
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