AUTOIMMUNIZATION AND ALLOIMMUNIZATION IN TRANSFUSION DEPENDANT THALASSEMIA MAJOR PATIENTS:STUDY ON 300 PATIENTS
Author(s): ,
Ayesha Younas
Affiliations:
Haematology,sundas foundation,Lahore,Pakistan
,
Adnan Ghias
Affiliations:
Haematology,sundas foundation,Lahore,Pakistan
Saima Farhan
Affiliations:
Haematology,sundas foundation,Lahore,Pakistan
EHA Library. younas A. Jun 15, 2019; 267213; PS1596
Ayesha younas
Ayesha younas
Contributions
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Abstract

Abstract: PS1596

Type: Poster Presentation

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

Location: Poster area

Background
Thalassemia is the most common genetic disorder worldwide and one of the major public health problems.Thalassemia patients are dependent on blood transfusions for their survival but they may be associated with many complications.Development of anti red blood cell antibodies(bot alloantibodies and autoantibodies) is one of them.There is a paucity of data on the incidence of alloimmunization and autoimmunization in thalassemic patients in Pakistan,as pre transfusion antibody screening is not routinely performed.Autoantibodies can result in clinical hemolysis and difficulty in cross matching blood.We studied the frequency of Red cell alloimmunization and autoimmunization among Thalassemia patients who received regular transfusions at Sundas Foundation and also to determine types of these antibodies among Thalassemia patients.

Aims
To study the frequency of Red Cell alloimmunization and autoimmunization among multiple transfused Thalassemia patients and to determine the types of these antibodies.

Methods
A total of 300 multiple transfused Thalassemia patients were included in this study.Clinical and serological records of all the patients were examined.Screening and identification of antibodies was performed on fresh serum of all patients using 3 cell and 11 cell panel respectively.Detection of autoantibodies was done using using polyspecific Coombs(IgG+C3d) gel cards.Approval of this study was taken from the institutional review board.Informed consent was provided.

Results
We identified alloantibodies in 17 patients,the most common were Anti E followed by Anti D,Anti C,Anti K,Anti Fyb,Anti-M.4 patients developed autoantibodies.

Conclusion
Alloimmunization is an immune respone stimulated by the transfusion of blood products.Overall rate of alloimmunization was 5.66% in our study while it is 30%/190 in Kuwait,4.97%/161 in India,5%/1435 in Italy,3.7%/1200 in Greece,5%/711 in Iran,9.2%/97 and 22.7%/75 in Pakistan.

Frequency of transfusion was 2-3 weeks in 13(61.9%) patients while in 7 (33.3%) patients it was 3-4 weeks.so,more units of blood transfused,more chances of alloimmunization and autoimmunization.There is no statistically significant gender difference.High prevelance of alloimmunization and autoimmunization was observed in Splenectomised patients in many studies but we could not find any relation.

This study emphasis on the importance of RBC antigen typing before the first transfusion so that the patient can be transfused with antigen matched blood (atleast for Rh and Kell antigen).The frequency of transfusion was increased in patients who developed alloantibodies.Phenotype determination of RBCs before beginning chronic blood transfusion and careful cross matching with Kell and Rh subgroups in addition to ABO may help reduce alloimmunization and frequency of transfusion in Thalassemia patients.

 

 

Session topic: 31. Transfusion medicine

Keyword(s): ABO blood group, Antibody, Blood transfusion, Thalassemia

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