Frequency of Red Blood Cell Alloimmunization in Patients with Sickle Cell Disease in Palestine

Background. Transfusion of red blood cells (RBC) is an essential therapeutic tool in sickle cell disease (SCD). Repeated RBC transfusions can cause alloimmunization which causes difficulty in cross-matching and finding compatible blood for transfusions. This study aimed to investigate the frequency...

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Main Authors: Fekri Samarah, Mahmoud A. Srour, Dirgham Yaseen, Kamal Dumaidi
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Advances in Hematology
Online Access:http://dx.doi.org/10.1155/2018/5356245
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author Fekri Samarah
Mahmoud A. Srour
Dirgham Yaseen
Kamal Dumaidi
author_facet Fekri Samarah
Mahmoud A. Srour
Dirgham Yaseen
Kamal Dumaidi
author_sort Fekri Samarah
collection DOAJ
description Background. Transfusion of red blood cells (RBC) is an essential therapeutic tool in sickle cell disease (SCD). Repeated RBC transfusions can cause alloimmunization which causes difficulty in cross-matching and finding compatible blood for transfusions. This study aimed to investigate the frequency of RBC alloimmunization and related risk factors among Palestinian SCD patients. Materials and Methods. A multicenter cross-sectional study on 116 previously transfused SCD patients from three centers in West Bank, Palestine. Demographic, medical data and history of transfusion were recorded. Blood samples were collected from transfused consenting SCD patients. Gel card method was used for antibody screening and identification. In all patients, autocontrol and direct antiglobulin (DAT) test were performed using polyspecific (anti-IgG + C3d) anti-human globulin (AHG) gel cards for the detection of autoantibodies. Results. Of the SCD patients, 62 (53.4%) patients were HbSS and 54 (46.6%) patients were sickle β-thalassemia (S/β-thal). There were 53 (45.7%) females and 63 (54.3%) males. Mean age was 18.8 years (range 3-53 years). The frequency of RBC alloimmunization among SCD patients was 7.76%, with anti-K showing the highest frequency (33.3%) followed by anti-E (22.2%), anti-D (11.1%), anti-C (11.1%), and anti-c (11.1%). All reported IgG alloantibodies were directed against antigens in the Rh (66.7%) and Kell (33.3%) systems. Older ages of patients, increased number of blood units transfused, and splenectomy were the commonest risk factors for alloimmunization in our study. Conclusions. RBC alloimmunization rate among Palestinian SCD patients is low compared to neighboring countries and countries all over the world but still warrants more attention. Phenotyping of donors/recipients’ RBC for Rh antigens and K1 (partial phenotype matching) before their first transfusion may reduce the incidence of alloimmunization.
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spelling doaj-art-1a75271c6c0d48f88bf4275e9b15ef762025-02-03T06:46:26ZengWileyAdvances in Hematology1687-91041687-91122018-01-01201810.1155/2018/53562455356245Frequency of Red Blood Cell Alloimmunization in Patients with Sickle Cell Disease in PalestineFekri Samarah0Mahmoud A. Srour1Dirgham Yaseen2Kamal Dumaidi3Department of Medical Technology, Faculty of Allied Health Sciences, Arab American University in Jenin, State of PalestineDepartment of Biology and Biochemistry, Faculty of Science, Birzeit University, Birzeit, State of PalestineRafidia Governmental Hospital, Ministry of Health, Nablus, State of PalestineDepartment of Medical Technology, Faculty of Allied Health Sciences, Arab American University in Jenin, State of PalestineBackground. Transfusion of red blood cells (RBC) is an essential therapeutic tool in sickle cell disease (SCD). Repeated RBC transfusions can cause alloimmunization which causes difficulty in cross-matching and finding compatible blood for transfusions. This study aimed to investigate the frequency of RBC alloimmunization and related risk factors among Palestinian SCD patients. Materials and Methods. A multicenter cross-sectional study on 116 previously transfused SCD patients from three centers in West Bank, Palestine. Demographic, medical data and history of transfusion were recorded. Blood samples were collected from transfused consenting SCD patients. Gel card method was used for antibody screening and identification. In all patients, autocontrol and direct antiglobulin (DAT) test were performed using polyspecific (anti-IgG + C3d) anti-human globulin (AHG) gel cards for the detection of autoantibodies. Results. Of the SCD patients, 62 (53.4%) patients were HbSS and 54 (46.6%) patients were sickle β-thalassemia (S/β-thal). There were 53 (45.7%) females and 63 (54.3%) males. Mean age was 18.8 years (range 3-53 years). The frequency of RBC alloimmunization among SCD patients was 7.76%, with anti-K showing the highest frequency (33.3%) followed by anti-E (22.2%), anti-D (11.1%), anti-C (11.1%), and anti-c (11.1%). All reported IgG alloantibodies were directed against antigens in the Rh (66.7%) and Kell (33.3%) systems. Older ages of patients, increased number of blood units transfused, and splenectomy were the commonest risk factors for alloimmunization in our study. Conclusions. RBC alloimmunization rate among Palestinian SCD patients is low compared to neighboring countries and countries all over the world but still warrants more attention. Phenotyping of donors/recipients’ RBC for Rh antigens and K1 (partial phenotype matching) before their first transfusion may reduce the incidence of alloimmunization.http://dx.doi.org/10.1155/2018/5356245
spellingShingle Fekri Samarah
Mahmoud A. Srour
Dirgham Yaseen
Kamal Dumaidi
Frequency of Red Blood Cell Alloimmunization in Patients with Sickle Cell Disease in Palestine
Advances in Hematology
title Frequency of Red Blood Cell Alloimmunization in Patients with Sickle Cell Disease in Palestine
title_full Frequency of Red Blood Cell Alloimmunization in Patients with Sickle Cell Disease in Palestine
title_fullStr Frequency of Red Blood Cell Alloimmunization in Patients with Sickle Cell Disease in Palestine
title_full_unstemmed Frequency of Red Blood Cell Alloimmunization in Patients with Sickle Cell Disease in Palestine
title_short Frequency of Red Blood Cell Alloimmunization in Patients with Sickle Cell Disease in Palestine
title_sort frequency of red blood cell alloimmunization in patients with sickle cell disease in palestine
url http://dx.doi.org/10.1155/2018/5356245
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