Massimo Franchini1,2, Gian Luca Forni3, Giuseppe Marano1, Mario Cruciani1,4, Carlo Mengoli1, Valeria Pinto3, Lucia De Franceschi5, Donatella Venturelli6, Maddalena Casale7, Martina Amerini1,8, Martina Capuzzo9, Giuliano Grazzini1,8, Francesca Masiello1, Ilaria Pati1, Eva Veropalumbo1, Stefania Vaglio1,10, Simonetta Pupella1, Giancarlo M Liumbruno1. 1. Italian National Blood Centre, National Institute of Health, Rome, Italy. 2. Department of Haematology and Transfusion Medicine, "Carlo Poma" Hospital, Mantua, Italy. 3. Centre for Microcythemia and Congenital Anaemia, "Galliera" Hospital, Genoa, Italy. 4. Infection Control Committee and Antibiotic Stewardship Programme, AULSS9 "Scaligera", Verona, Italy. 5. Department of Medicine, University of Verona and AOUI-Verona, Policlinico "G.B. Rossi", Verona, Italy. 6. Department of Transfusion Medicine, University Hospital of Modena, Modena, Italy. 7. Department of Women, Children and General and Specialised Surgery, "Luigi Vanvitelli" University of Campania, Naples, Italy. 8. Italian Foundation for Research on Anaemia (FORANEMIA) and Haemoglobinopathies, Genoa, Italy. 9. Mother-Infant Department, University of Modena and Reggio Emilia, Modena, Italy. 10. Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Rome, Italy.
Abstract
BACKGROUND: Chronic red blood cell transfusion is the first-line treatment for severe forms of thalassaemia. This therapy is, however, hampered by a number of adverse effects, including red blood cell alloimmunisation. The aim of this systematic review was to collect the current literature data on erythrocyte alloimmunisation. MATERIALS AND METHODS: We performed a systematic search of the literature which identified 41 cohort studies involving 9,256 patients. RESULTS: The prevalence of erythrocyte alloimmunisation was 11.4% (95% CI: 9.3-13.9%) with a higher rate of alloimmunisation against antigens of the Rh (52.4%) and Kell (25.6%) systems. Overall, alloantibodies against antigens belonging to the Rh and Kell systems accounted for 78% of the cases. A higher prevalence of red blood cell alloimmunisation was found in patients with thalassaemia intermedia compared to that among patients with thalassaemia major (15.5 vs 12.8%). DISCUSSION: Matching transfusion-dependent thalassaemia patients and red blood cell units for Rh and Kell antigens should be able to reduce the risk of red blood cell alloimmunisation by about 80%.
BACKGROUND: Chronic red blood cell transfusion is the first-line treatment for severe forms of thalassaemia. This therapy is, however, hampered by a number of adverse effects, including red blood cell alloimmunisation. The aim of this systematic review was to collect the current literature data on erythrocyte alloimmunisation. MATERIALS AND METHODS: We performed a systematic search of the literature which identified 41 cohort studies involving 9,256 patients. RESULTS: The prevalence of erythrocyte alloimmunisation was 11.4% (95% CI: 9.3-13.9%) with a higher rate of alloimmunisation against antigens of the Rh (52.4%) and Kell (25.6%) systems. Overall, alloantibodies against antigens belonging to the Rh and Kell systems accounted for 78% of the cases. A higher prevalence of red blood cell alloimmunisation was found in patients with thalassaemia intermedia compared to that among patients with thalassaemia major (15.5 vs 12.8%). DISCUSSION: Matching transfusion-dependent thalassaemia patients and red blood cell units for Rh and Kell antigens should be able to reduce the risk of red blood cell alloimmunisation by about 80%.
Authors: Mohammad Hadi Sadeghian; Mohammad Reza Keramati; Zahra Badiei; Mehrangiz Ravarian; Hossein Ayatollahi; Houshang Rafatpanah; Mohammad Khajeh Daluei Journal: Asian J Transfus Sci Date: 2009-07
Authors: Sarah J Waldis; Stacey Uter; Donna Kavitsky; Cynthia Flickinger; Sunitha Vege; David F Friedman; Connie M Westhoff; Stella T Chou Journal: Blood Adv Date: 2021-02-09