Predictors of Red Cell Alloimmunization in Kurdish Multi Transfused Patients with Hemoglobinopathies in Iraq.
Hemoglobinopathies are significant health problems in Iraq, including its Northern Kurdistan region. One of the essential components of management of these disorders is regular lifelong blood transfusions. The latter is associated with several complications including red cell alloimmunization. No study has looked at the frequency of alloimmunization and its associations in the country. To address the latter issue, 401 multi transfused patients [311 with β-thalassemia (β-thal) syndrome and 90 with sickle cell disease], registered at a large thalassemia care center in Iraqi Kurdistan had their records reviewed, and their sera tested for atypical antibodies using screening and extended red cell panels. Red cell alloimmunization was detected in 18 patients (4.5%) with a total of 20 alloantibodies, while no autoantibodies were detected. The most frequent alloantibody was anti-E, followed by anti-D, anti-K, anti-C(w), anti-C, anti-c and anti-Le(a). Ethnicity was an important predictor of alloimmunization, while age at start of transfusion (>2 vs. ≤2 years) (p = 0.005), Rhesus D (RhD) negative status (p = 0.0017) and history of previous transfusion reactions (p = 0.007) showed a statistically significant higher rate of alloimmunization. However, patients' age, gender, number of units transfused, underlying diagnosis and splenectomy were not significantly associated with alloimmunization. Based on our observations, measures to reduce alloimmunization rates may include extended matching for Rhesus and Kell antigens and early initiation of blood transfusions.
a Department of Haematology , Azadi Teaching Hospital , Duhok , Iraq.
Muqdad M N
MM
Al-Mousawi
b Scientific Research Centre, Faculty of Medical Sciences, University of Duhok , Duhok , Iraq.
Nasir A S
NA
Al-Allawi
c Thalassaemia Care Centre , Duhok , Iraq.
Rubad
R
Alnaqshabandi
D000017:ABO Blood-Group System / Q000276:immunology; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004912:Erythrocytes / Q000276:immunology*; D005260:Female; D006453:Hemoglobinopathies / Q000453:epidemiology / Q000276:immunology* / Q000628:therapy*; D006801:Humans; D007223:Infant; D007493:Iraq / Q000453:epidemiology; D007518:Isoantibodies / Q000276:immunology*; D008297:Male; D012204:Rh-Hr Blood-Group System / Q000276:immunology; D065227:Transfusion Reaction; D055815:Young Adult
D000017:ABO Blood-Group System; D007518:Isoantibodies; D012204:Rh-Hr Blood-Group System
Alloimmunization; Iraq; hemoglobinopathies; sickle cell disease; β-thalassemia (β-thal)