BACKGROUND: Red blood cell transfusion has greatly reduced the mortality and morbidity in multiply transfused thalassemia and sickle cell patients. However this can result in red blood cell isoimmunization with autoantibodies and alloantibodies which can lead to serious complications such as delayed hemolytic transfusion reaction.
OBJECTIVE: To assess the frequency and types of alloantibodies in multiply transfused patients in the north of the West Bank.
METHODS: This pilot study was performed at three Thassemia Centers in the Northern districts of Palestine where 300 thalassemic and sickle cell patients regularly receive their blood transfusions. A sample of 131 multiply-transfused patients from the three centers in Nablus, Jenin, and Tulkarm were included. Clinical and transfusion records of all included patients were examined for age of patients, age at initiation of transfusion therapy, total number of blood units transfused, and status of splenectomy. Alloantibody screening and identification was done using three cell and 11 cell panel (DiaPanel, Bio-rad, Switzerland) respectively.
RESULTS: Twenty out of 131 patients (15.3%) had alloantibodies. Fourteen of them were diagnosed as B thalassemia Major (70%), three were diagnosed as sickle cell anemia (15%), two were diagnosed as thalssemia intermedia (10%) and one was diagnosed as sickle cell thalassemia (5%). Thirteen Out of the 20 (65%) had alloantibodies belonged to Rh blood group system (nine (45%) anti-D, two (10%) anti-E, one (5%) anti Rh-C and one (5%) anti-c). Anti-Kell (K) was found in 7 (35%) patients.
CONCLUSION: Our data showed quite high alloimmunization rate in multiply transfused patients. Rh and Kell blood group system antibodies were the only alloantibodies identified in this study. In order to reduce alloimmunization, a policy for performing extended red cell phenotyping of these patients and issuing of antigen matched blood (at least for Rh and Kell antigen) is essential.