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Red Blood Cell Allo and Autoantibody Production in Patients in the Thalassemia Clinical Research Network

Authors :
Melody J. Cunningham
Nancy F. Olivieri
Patricia J. Giardina
Alexis A. Thompson
Eric A. Macklin
Sylvia T. Singer
Catherine S. Manno
Source :
Blood. 106:1890-1890
Publication Year :
2005
Publisher :
American Society of Hematology, 2005.

Abstract

Introduction: The development of alloantibodies and/or autoantibodies, complicates red blood cell (RBC) crossmatching, shortens red cell survival, delays provision of safe transfusion and may accelerate tissue iron loading. Little is known about the incidence of alloimmunization or its inciting factors, essential data for strategies to provide optimal transfusion. Aim: To determine the frequency of RBC allo- and autoantibodies in patients with thalassemia major (TM) who are regularly transfused and whether there is an association of RBC antibodies and age at initiation of transfusion, duration of regular transfusion, splenectomy status, transfusion of leukoreduced blood or ethnicity. Methods: We utilized a cross-sectional registry of the Thalassemia Clinical Research Network (TCRN), an NHLBI-funded consortium of patients with thalassemia followed in Canada and the United States, for data on allo- and autoantibodies, splenectomy status, ethnicity and compared rates before and after 1990, when the first leukoreduction filters were introduced. Results: 502 of the 836 subjects enrolled in the TCRN registry had been regularly transfused and reported allo- and autoimmunization status. Allo- and autoantibodies were reported in 104 (21%) and 46 (9.2%) subjects, respectively. Presence of both were reported in 26 (5.2%) individuals. The rate of alloimmunization was higher among individuals who initiated transfusions prior to 1990 (27%) versus those who initiated transfusion after that date (12.5%, p Conclusions: RBC allo- and autoimmunization continue to develop in chronically transfused thalassemia patients although the availability of leukoreduced RBC may have resulted in the lower immunization rate observed in younger patients. The risk for RBC immunization that splenectomy imparts is concerning and deserves closer analysis.

Details

ISSN :
15280020 and 00064971
Volume :
106
Database :
OpenAIRE
Journal :
Blood
Accession number :
edsair.doi...........cb7685d2c15c730b16c48610481194ad
Full Text :
https://doi.org/10.1182/blood.v106.11.1890.1890