HLA-DRB1*15 INCREASES THE RISK OF RED BLOOD CELLS ALLOANTIBODIES IN PATIENTS WITH BETA THALASSEMIA MAJOR
Author(s): ,
Louza Ali Al Mashaykhi
Affiliations:
Oman medical speciality board, Sultan Qaboos University Hospital,Muscat,Oman
,
Murtadha K. Al-Khabori
Affiliations:
Sultan Qaboos University Hospital,Muscat,Oman
,
Hamad Al-Riyami
Affiliations:
Sultan Qaboos University Hospital,Muscat,Oman
,
Bader Al-Rawahi
Affiliations:
Sultan Qaboos University Hospital,Muscat,Oman
,
Yasser Wali
Affiliations:
Sultan Qaboos University Hospital,Muscat,Oman
Shahina Daar
Affiliations:
Sultan Qaboos University Hospital,Muscat,Oman
EHA Library. Al Mashaykhi L. Jun 15, 2019; 267191; PS1574
Dr. Louza Al Mashaykhi
Dr. Louza Al Mashaykhi
Contributions
Abstract

Abstract: PS1574

Type: Poster Presentation

Presentation during EHA24: On Saturday, June 15, 2019 from 17:30 - 19:00

Location: Poster area

Background
The cornerstone of the management of Beta Thalassemia Major (B-TM) is lifelong Red Blood Cells (RBC) transfusion. This is associated with the development of RBCs alloantibodies. Human Leukocyte Antigen (HLA) is considered a risk factor for a number of autoimmune disorders. We hypothesized that HLA impacts the rate of alloantibody formation in patients with B-TM.

Aims
To assess the impact of HLA alleles on the risk of RBC alloimmunization in patients with B-TM.

Methods
This is a retrospective cohort study of patients with B-TM managed at Sultan Qaboos University Hospital (SQUH) between January 1996 till December 2016. All adult and paediatric patients with B-TM with available HLA typing results were included. Patients with missing data were excluded. Chi-squared test was used to assess the impact of HLA alleles on alloimmunization and the effect size was estimated using odd ratio (OR). HLA testing was performed using polymerase chain reaction – specific sequence of oligonucleotides (PCR-SSO). Gel card technique (BIORAD ID-System; DiaClon, Bio-Rad, DiaMed GmbH, Switzerland) was used to screen for the RBC alloantibodies.

Results
One hundred and sixty-five patients fulfilled the inclusion criteria without missing information. The median age of all patients was 14 years. Females constituted 48% of the sample and 45% of patients were O RhD positive. The median RBC transfusion was 17 times per year. Patients were first detected to have RBC alloantibody at a median age of 16 years. The commonest RBC alloantibodies found in these patients were anti-K (50%) and anti-E (58%). The commonest HLA allele in loci A, B, C, DQ and DRB1 were HLA-A*02 (21%), HLA-B*51 (14%), HLA-C*7 (18%), HLA-DQ*05 (47%) and HLA-DRB1*16 (32%) respectively. HLA-DRB1*15 and HLA-DQ*6 were associated with a higher risk of RBC alloantibody formation (HLA-DRB1*15: OR 3.57, P = 0.047; HLA-DQ*06: OR 4.37, P = 0.025). None of the remaining common alleles (>5%) in Omani population were associated with the risk of alloantibody formation (p values >0.05).

Conclusion
HLA-DRB1*15 and HLA-DQ*06 increases the risk of RBC alloantibody formation in patients with B-TM. We recommend extended RBC phenotyping and extended antigen matched blood transfusion in patients carrying these two alleles. These findings will need to be confirmed in a larger multicenter study.

Session topic: 27. Thalassemias

Keyword(s): HLA

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