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Alloimmunization to Red Cells and the Association of Alloantibodies Formation with Splenectomy Among Transfusion-Dependent β-Thalassemia Major/HbE Patients

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Indian Journal of Clinical Biochemistry Aims and scope Submit manuscript

Abstract

Severe hemolytic anemia in β-thalassemia major and β-thalassemias/HbE (β-TM) patients requires giving blood transfusions. Chronic blood transfusions lead to iron overload consequence with organs damage and risk of alloantibody-formation. This study evaluates the prevalence of red cell alloimmunization and estimates the risk of alloantibody-formation in chronic transfusion-dependent β-TM patients. This cross sectional study was conducted on 143 β-TM patients receiving regular transfusions. We tried to determine the frequency, types and factors influencing red cell alloimmunization in these transfusion-dependent β-TM patients. Median age of 25 (17.5 %) alloantibody-formation β-TM patients was 19.0 years (inter quartile 15.5–24.0 years). The alloantibodies were Anti-Rh (E) (13.1 %), Anti-Rh (D) (0.7 %). Thirty-four patients (23.8 %) of the sample had splenectomies of which 10 (29.4 %) had alloantibody-formation. The interval from first transfusion to antibody development varied from 1.5 to 14 years. Alloantibody-formation correlated with splenectomy and splenectomy correlated with number of transfusion (p < 0.005). In multiple logistic regression used to estimate the risk of alloantibodies formation with splenectomy; OR and 95 % CI were 2.88 (1.07–7.80), p = 0.037 after adjusting for other co-variates. The rate of red cell alloimmunization was 17.5 % and splenectomy associated with increased alloantibody-formation in these transfusion-dependent β-TM patients.

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Abbreviations

β-TM patients:

β-Thalassemia major and β-thalassemias/HbE patients

DHTR:

Delayed haemolytic transfusion reaction

BMI:

Body mass index

WBC:

White blood cell

RBC:

Red blood cell

NRBC:

Nucleated red blood cells

Hb:

Hemoglobin

Hct:

Hematocrit

CGA:

Column gel agglutination

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Acknowledgments

We sincerely thank Department of Clinical Pathology, Nan Hospital for financial support. We also sincerely thank all co-workers in the Blood Bank Unit of Nan Hospital, for blood collection and their technical help. We especially thank those who participated and donated blood samples for this study. Finally we sincerely thank Asst. Prof. Dr. Ronald A. Markwardt, Faculty of Public Health, Burapha University, for his critical reading and correcting of the manuscript.

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Authors and Affiliations

  1. Department of Clinical Pathology, Nan Hospital, Nan, 55000, Thailand

    Suteenee Jansuwan

  2. Chronic Diseases Research Unit, Department of Medical Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, 65000, Thailand

    Orathai Tangvarasittichai & Surapon Tangvarasittichai

  3. Chronic Diseases Research Unit, Department of Optometry, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, 65000, Thailand

    Surapon Tangvarasittichai

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  1. Suteenee Jansuwan
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  2. Orathai Tangvarasittichai
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Correspondence to Surapon Tangvarasittichai.

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Jansuwan, S., Tangvarasittichai, O. & Tangvarasittichai, S. Alloimmunization to Red Cells and the Association of Alloantibodies Formation with Splenectomy Among Transfusion-Dependent β-Thalassemia Major/HbE Patients. Ind J Clin Biochem 30, 198–203 (2015). https://doi.org/10.1007/s12291-014-0424-6

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