Evaluation of Red Cell Alloimmunization in Thalassemic Patients with Repeated Blood Transfusion

Abstract
Background: Thalassemia is a group of inherited disorders that arise as a result of certain mutations in hemoglobin (Hb) genes, affecting the synthesis of globin chain (a, (3), which leads to certain pathophysiological disorders as chronic hemolytic anemia and ineffective erythropoiesis. Patients who suffered from thalassemia receive blood transfusion regularly every month or even less than month according to the severity of hemolysis. Repeated blood transfusion results in many complications including formation of alloantibodies or au-toantibodies against transfused RBCs.
Aim of the Study: To evaluate alloantibodies and autoan-tibodies formation in thalassemic patients with repeated blood transfusion and try to avoid hemolytic transfusion reaction which may occur during future blood transfusion.
Patients and Methods: The present study was carried on a hundred (100) pediatric thalassemic patients. All included subjects were submitted to full history taking, clinical exam-ination and laboratory investigations. Screening gel tests for allo and autoantibodies.
Results: We found that the frequency of development of red cell alloimmunization in thalassemic patients receiving multiple blood transfusions is 26% and autoantibodies 0%. The most frequently occurring alloantibodies was anti k (13%), anti Jsb (13%), anti Lub (13%), anti D (5%), anti Jka (5%), anti M (5%), anti S (5%), anti Kpa (4%), anti N (4%), anti C (3%), anti Lea (3%), anti c (1%), anti Fyb (1%), anti Lea (1%) and anti p1 (1%).
Conclusion: Thalassemic patients with repeated blood transfusion develop a significant rate of alloantibodies. Some of these antibodies are clinically significant and may affect the safety of further blood transfusion and cause hemolytic transfusion reaction. So antibody screening test should be performed to patients with chronic transfusion to avoid the hazardous of future transfusion.