Study of alloimmunization in thalassemia major
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 311-319
AbstractThalassemia Major results in a severe anemia and require regular blood transfusion every 3-4 weeks. The regular blood transfusion regimen causes production of alloantibodies against one or more red cell antigens, which complicates subsequent transfusions.
Aims and objectives:
1. To find out incidence of various RBC alloantibodies in repeatedly transfused thalassemic patients.
2. To initiate pre-transfusion antibody screening on patient’s sample before cross match.
3. To analyse factor responsible for development of antibodies.
Material and method: It was prospective observational study conducted at Civil Hospital Ahmedabad from 01/09/2018 to 31/08/2020.Transfusion dependent patients of age up to 12 years having more than 50 blood transfusion were included in the study. Blood samples were collected in pilot tubes (EDTA and plain). The plasma/serum was used for antibody screening and antibody identification test using 3-cell panel and 11-cell panel. Serological parameters tested were blood grouping, Direct Antiglobulin Test (DAT), Indirect Antiglobulin Test (IAT) and antibody screening and identification. Blood grouping was done by using DIAGAST (QWALYS) on Erythrocyte Magnetized Technology (EMT). Results were obtained and data was analysed.
Observation and results: In alloimmunized patients M:F ratio was 1:3. The mean of total number of blood transfusion of all the patients and alloimmunized was 127 and 233. It shows more chances of developing alloantibodies with higher number of blood transfusion. Out of total alloimmunized patients, 50% patients were splenectomised. Alloantibodies was present in 50% patients with O+ blood group, 25% with A-and 25% with B+. Anti-K alloantibody was found in 50% patients, Anti-D in 25% patient and Anti-E in 25%. Total 91% patients were having annual blood requirement <200 (ml/kg/year) and 9% having >=200 (ml/kg/year). Among them, all the alloantibodies present patients found having annual blood requirement >=200 (ml/kg/year). All alloimmunized patients were having Homozygous thalassemia.
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