Alloimmunization against platelets, granulocytes and erythrocytes in multi-transfused patients in Iranian population.
BACKGROUND
This study aims at alloantibody screening, determination of the types of these antibodies in multiple-transfused patients with chronic hematologic diseases.


METHODS
This descriptive study was performed on 240 patients with chronic hematological diseases referred to public hospitals in Iran. Single blood sample was taken and tested for the presence of antibodies. In case of a positive antibody screening, antibody identification was performed using granulocyte agglutination test (GAT), granulocyte indirect immunofluorescence test (GIIFT), platelet indirect immunofluorescence test (PIIFT), monoclonal antibody-specific immobilization of platelet antigen (MAIPA) and panel cells.


RESULTS
Out of 240 patients, 105 patients (43.75 %) had been alloimmunized. The incidence of alloantibodies against red blood cells (RBCs) in positive alloantibodies patients were 84.76% (89/105). The most common alloantibody was against antigens of the kell (anti-K) and Rh (anti-E) and (anti D) systems (46.66%, 18.09% and 11.43% respectively). The overall incidence of anti- human leukocyte antigen (HLA) antibodies were 65.7% (69/105). Polymorphonuclear (PMN)-specific antibodies were found in 6.66% (7/105). Also from 105 patients, 14 patients had alloantibodies against platelet.


CONCLUSIONS
In general, it is recommend that to decrease the rate of alloantibody synthesis, the packed cells should be cross matched for minor blood groups especially for Rh (E) and kell. In addition, the use of leukodepleted blood products can decrease the frequency of alloimmunization against platelet (PLT), PMN and HLA antigens.
Hematology Department, Allied Medical School, Tehran University of Medical Sciences, Tehran, Iran.
Mohammad Reza
MR
Younesi
Hematology Laboratory, Oncology Ward, Shariati Hospital Tehran, Iran.
Samira
S
Louni Aligoudarzi
Department of Genetic, Varamin - Pishva Branch, Islamic Azad University, Tehran, Iran.
Razieh
R
Bigdeli
Biochemistry Laboratory, Imam Khomeini Hospital Complex, Vali-e-Asr Hospital, Tehran, Iran.
Marzieh
M
Lashgari
Hematology Laboratory, Oncology Ward, Shariati Hospital Tehran, Iran.
Hoda
H
Mazaheri
Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: vahid.asgary@yahoo.com.
Vahid
V
Asgary
D000293:Adolescent; D000328:Adult; D000368:Aged; D001792:Blood Platelets / Q000276:immunology* / Q000378:metabolism; D002648:Child; D004912:Erythrocytes / Q000276:immunology* / Q000378:metabolism; D005260:Female; D006098:Granulocytes / Q000276:immunology* / Q000378:metabolism; D006801:Humans; D007518:Isoantibodies / Q000097:blood / Q000276:immunology; D007626:Kell Blood-Group System / Q000097:blood / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012203:Rh Isoimmunization / Q000097:blood / Q000453:epidemiology / Q000276:immunology*; D012204:Rh-Hr Blood-Group System / Q000097:blood / Q000276:immunology*; D065227:Transfusion Reaction
D007518:Isoantibodies; D007626:Kell Blood-Group System; D012204:Rh-Hr Blood-Group System
Alloimmunization; Erythrocytes; Granulocytes; Multi-transfused patients; Platelets