Prevalence of Alloantibodies in Thalassemia Patients and Its Relationship With Age, Gender and Blood Group
,
Abstract
To determine the prevalence of alloantibodies in patients with thalassemia and its relationship with age, sex, and blood group. A cross-sectional study was conducted on thalassemia patients requiring a blood transfusion presenting to Children’s Medical Center and Bahmari Hospital in 2021. All patients who received blood transfusions in the first year of life were included in the study, and patients with sickle cell anemia and thalassemia intermedia were excluded. Blood samples were collected, and the level of alloantibodies was measured. One hundred and ninety-five patients were evaluated in this study, of whom 100 (51.3%) were male. The mean age of the subjects was 21.37±8.57 years (range: 1-42 years). The prevalence of alloantibody positivity was 16.41% (11.17-21.65) in all subjects, 19% (11.18-26.82) in males, and 13.68% (6.65-20.72) in females (P=0.318). The mean age of alloantibody positive and negative subjects was 18.94±9.7 and 21.85±8.29 years, respectively (P=0.079). The prevalence of alloantibody positivity was 21.88% (6.73-37.02) in Rh+ and 15.34% (9.75-20.93) in Rh- patients (P=0.364). The prevalence of alloantibody positivity was 13.46% (3.87-23.06) in blood type A, 26.67% (1.32-52.02) in blood type AB, 14.29% (3.25-25.32) in blood type B, and 17.44% (9.26-25.63) in blood type O, indicating no significant difference in this regard (P=0.625). The results showed that thalassemia patients were at risk for alloantibody positivity. Age, sex, and blood type had no significant association with the prevalence of alloantibody positivity. Considering the serious complications of these antibodies, these patients should be continuously screened for the presence of alloantibodies.
2. Jaing TH, Chang TY, Chen SH, Lin CW, Wen YC, Chiu CC. Molecular genetics of β-thalassemia. Medicine (Baltimore) 2021;100:e27522.
3. De Sanctis V, Kattamis C, Canatan D, Soliman AT, Elsedfy H, Karimi M, et al. β-Thalassemia Distribution in the Old World: an Ancient Disease Seen from a Historical Standpoint. Mediterr J Hematol Infect Dis 2017;9:e2017018.
4. Abu-Shaheen A, Heena H, Nofal A, Abdelmoety DA, Almatary A, Alsheef M, et al. Epidemiology of Thalassemia in Gulf Cooperation Council Countries: A Systematic Review. Biomed Res Int 2020;2020:1509501.
5. El-Beshlawy A, Salama AA, El-Masry MR, El Husseiny NM, Abdelhameed AM. A study of red blood cell alloimmunization and autoimmunization among 200 multitransfused Egyptian β thalassemia patients. Sci Rep 2020;10:21079.
6. Tangvarasittichai S. Impact of alloimmunization on transfusion‐dependent patients. Ann Adv Chem 2017;1:70-82.
7. Huang H, Xu L, Chen M, Lin N, Xue H, Chen L, et al. Molecular characterization of thalassemia and hemoglobinopathy in Southeastern China. Sci Rep 2019;9:3493.
8. Al-Joudi F, Ali AB, Ramli MB, Ahmed S, Ismail M. Prevalence and specificities of red cell alloantibodies among blood recipients in the Malaysian state of Kelantan. Asian J Transfuse Sci 2011;5:42-5.
9. Amin M, Gholamhossein T, Majid N, Marziyeh H, Narges S, Akbar D. Prevalence of alloimmunization against RBC antigens in thalassemia major patients in Southeast of Iran. J Blood Disorders Transf 2013;4:2.
10. Kiani AA, Abdi J, Shirkhani Y, M Kashi. Prevalence of alloimmunization against RBC antigens in thalassemia major patients of Lorestan province in 2004. Blood (J Iran Blood Transfus Organ Res Cent) 2006;3:265-71.
11. Kosaryan M, Mahdavi MR, Roshan P, Hojjati MT. Prevalence of alloimmunisation in patients with beta thalassemia major. Blood Transfus 2012;10:396-7.
12. Jeengar RK, Upadhyaya A, Agarwal N, Mehta A. Red cell alloimmunization in repeatedly transfused children with beta thalassemia major. Int J Contemp Pediatr 2017;4:5.
13. Singer ST, Wu V, Mignacca R, Kuypers FA, Morel P, Vichinsky EP. Alloimmunization and erythrocyte autoimmunization in transfusion-dependent thalassemia patients of predominantly Asian descent. Blood 2000;96:3369-73.
14. Al-Mousawi MM, Al-Allawi NA, Alnaqshabandi R. Predictors of Red Cell Alloimmunization in Kurdish Multi Transfused Patients with Hemoglobinopathies in Iraq. Hemoglobin 2015;39:423-6.
15. Thompson AA, Cunningham MJ, Singer ST, Neufeld EJ, Vichinsky E, Yamashita R, et al. Red cell alloimmunization in a diverse population of transfused patients with thalassemia. Br J Haematol 2011;153:121-8.
16. Sahu A, Parida P, Mahapatra S, Sahoo BB. Detection of red cell alloantibodies in thalassemia patients. Int J Contemp Pediatr 2020;7:5.
17. Hussein E, Desooky N, Rihan A, Kamal A. Predictors of Red Cell Alloimmunization in Multitransfused Egyptian Patients With β-Thalassemia. Arch Pathol Lab Med 2014;138:684-8.
18. Abdelrazik AM, Elshafie SM, El Said MN, Ezzat Ahmed GM, Al-Gamil AK, El Nahhas MG, et al. Study of red blood cell alloimmunization risk factors in multiply transfused thalassemia patients: role in improving thalassemia transfusion practice in Fayoum, Egypt. Transfusion 2016;56:2303-7.
19. Eghbali A, Rahimi-Afzal R, Mehrabi S, Sanatkar A, Mousavi Hasanzadeh M. Frequency and Risk Factors of Red Blood Cell Alloimmunization in Thalassemia Major Patients in Markazi province. Iran J Ped Hematol Oncol 2019;9:25-31 .
20. Abdulqader AM, Mohammed AI, Mohammed NI. Red Cell Alloimmunization and Autoimmunization in Multi-Transfused Thalassemia Patients in Sulaymaniyah Province-Iraq. Korean J Clin Lab Sci 202;52:98-104.
21. Chao YH, Wu KH, Lu JJ, Shih MC, Peng CT, Chang CW. Red blood cell alloimmunisation among Chinese patients with β-thalassemia major in Taiwan. Blood Transfus 2013;11:71-4.
22. Ahmed AM, Hasan NS, Ragab SH, Habib SA, Emara NA, Aly AA. Red cell alloimmunization and autoantibodies in Egyptian transfusion-dependent thalassemia patients. Arch Med Sci 2010;6:592-8.
23. el-Danasoury AS, Eissa DG, Abdo RM, Elalfy MS. Red blood cell alloimmunization in transfusion-dependent Egyptian patients with thalassemia in a limited donor exposure program. Transfusion 2012;52:43-7.
24. Sadeghian MH, Keramati MR, Badiei Z, Ravarian M, Ayatollahi H, Rafatpanah H, et al. Alloimmunization among transfusion-dependent thalassemia patients. Asian J Transfus Sci 2009;3:95-8.
25. Obeidi N, Mankhian AR, Hatami G, Emami H. Antibody screening in patients with thalassemia major. Lab Med 2011;42:618-21.
26. Karimi M, Nikrooz P, Kashef S, Jamalian N, Davatolhagh Z. RBC alloimmunization in blood transfusion-dependent beta-thalassemia patients in southern Iran. Int J Lab Hematol 2007;29:321-6.
27. Azarkeivan A, Ahmadi MH, Gharehbaghian A, Zolfaghari S, Nasizadeh S, Maghsudlu M, et al. Antibody screening and identification by gel method in thalassemic patients. Sci J Iran Blood Transfus Organ 2008;5:99-108.
28. Keikhaei B, Far AH, Abolghasemi H, Mousakhani H, Ghanavat M, Moghadam M, et al. red blood cell alloimmunization in patients with thalassemia major and intermediate in southwest Iran. Iran J Blood Cancer 2013;6:41-6.
29. Noor Haslina MN, Ariffin N, Illuni Hayati I, Rosline H. Red cell immunization in multiply transfused Malay thalassemic patients. Southeast Asian J Trop Med Public Health 2006;37:1015-20.
30. Khalid H, Muhammad Y, Nadeem I, Lubna N, Hassan Z. Red cell alloimmunization in repeatedly transfused thalassemia major patients; 2004.
31. Ho HK, Ha SY, Lam CK, Chan GC, Lee TL, Chiang AK, et al. Alloimmunization in Hong Kong southern Chinese transfusion-dependent thalassemia patients. Blood 2001;97:3999-4000.
32. Ameen R, Al‐Shemmari S, Al‐Humood S, Chowdhury RI, Al‐Eyaadi O, Al‐Bashir A. RBC alloimmunization and autoimmunization among transfusion‐dependent Arab thalassemia patients. Transfusion 2003;43:1604-10.
33. Spanos T, Karageorga M, Ladis V, Peristeri J, Hatziliami A, Kattamis C. Red cell alloantibodies in patients with thalassemia. Vox Sang 1990;58:50-5.
| Files | ||
| Issue | Vol 61 No 1 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/acta.v61i1.12126 | |
| Keywords | ||
| Alloantibodies Thalassemia Blood group | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
