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Subject Area

Clinical Pathology

Article Type

Original Study

Abstract

Objective We aimed to find out the frequency of alloimmunization in multitransfused β-thalassemic patients, the most common alloantibodies involved, factors contributing to their development, and their impact on severity of the disease. Background Thalassemia is a major health problem in Egypt. It is an inherited hemolytic disorder. Blood transfusion, despite being a life-saving process, it is associated with inherent risks of alloimmunization against red-blood cell antigens. Patients and methods Blood samples from 200 multitransfused β-thalassemic patients who were regularly transfused with leukodepleted packed red-blood cells, matched only for ABO-Rh (D) antigens, were analyzed. The antibody screening and identification were performed by column-agglutination method. To detect autoantibodies, autocontrol and direct antiglobulin test was carried out in all patients. Adsorption test was not employed as there were not autoantibodies detected in any patient. Results Alloantibodies were detected in 18/200 (9.0%) patients. The most frequent alloantibodies were anti-Kell system (50%), Rh system (anti-D and anti-E are 16.75% for each). Alloimmunization significantly differed with gender, ABO and Rh blood group, frequency of blood transfusion, age at first transfusion, the number of blood units transfused, and serum ferritin (P < 0.01). Conclusion Alloimmunization was detected in 9.0% of patients. Most alloantibodies were anti-Kell followed by anti-Rh system. Serum ferritin level was significantly high in alloimmunized patients, which impacts on the severity of the disease. Antibody screening has to be done before each transfusion and extended red-cell phenotyping must be performed once diagnosed to prevent complications.

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