Abstract
Introduction: Each transfusion of red blood cell concentrates carries a risk of alloimmunization against erythrocyte antigens for recipients. The aim of this study is to evaluate the prevalence of alloimmunization among multi-transfused patients in antigen systems other than RH (such as Duffy, MNS, Kidd, etc.) and to examine its impact on the transfusion strategy adopted in Tunisia. Materials and Methods: This is a retrospective study conducted in the immunohematology laboratory of the Regional Blood Transfusion Center in Sousse, over a period of 3 years and 5 months from January 1, 2021, to May 31, 2024. Data collection was carried out using a pre-designed form based on the computerized system and the laboratory’s registry. Results: The study population consists of 9 alloimmunized patients, with a female predominance (6 out of 9 patients) and an average age of 40.78 years. Most patients developed only a single alloantibody (7 out of 9 patients). The most frequent alloantibodies were anti-M and anti-Jka (each observed in 3 out of 9 patients). An association of autoantibodies with alloantibodies was observed in 3 out of 9 patients. A compatibility rate of 53.88% for Red Blood Cell concentrates was observed. Conclusion : Extended phenotyping and the creation of donor registries with extended phenotypes could play a crucial role in enhancing transfusion safety, though economic constraints persist in Tunisia.
References
Baglo T, Zohoun A, Agboton BL, Vigan J, Ayaka P, Anani L, et al. Allo-immunisation anti-érythrocytaire chez les polytransfusés au Centre National Hospitalier Universitaire de Cotonou: à propos de 51 cas. Pan Afr Med J. 24 mars 2021;38:304.
Yonli YD, Nébié K, Yacouba S, Kiba A, Sawadogo S, Sawadogo SM, et al. Allo-immunisation chez les patients polytransfusés avec des concentrés de globules rouges non phénotypés au Centre Hospitalier Universitaire Souro Sanou de Bobo Dioulasso (Burkina Faso). Pan Afr Med J. 24 mars 2022;41:244.
Valle Neto OG do, Alves VM, Pereira G de A, Moraes-Souza H, Martins PRJ. Clinical and epidemiological profile of alloimmunized and autoimmunized multi-transfused patients against red blood cell antigens in a blood center of Minas Gerais. Hematol Transfus Cell Ther. 1 avr 2018;40(2):107‑11.
Makarovska-Bojadzieva T, Velkova E, Blagoevska M. The Impact of Extended Typing On Red Blood Cell Alloimmunization in Transfused Patients. Open Access Maced J Med Sci. 8 avr 2017;5(2):107‑11.
Bouzguenda S. PlACE DU PHENOTYPAGE ERYTHROCYTAIRE ETENDU DANS LA PRISE EN CHARGE DES POLYTRANSFUSES [Rétrospective]. [Tunisie]: Faculté de pharmacie de monastir; 2020.
Abu Taha A, Yaseen A, Suleiman S, Abu Zenah O, Ali H, Abu Seir R, et al. Study of Frequency and Characteristics of Red Blood Cell Alloimmunization in Thalassemic Patients: Multicenter Study from Palestine. Adv Hematol. 12 nov 2019;2019:e3295786.
Alkindi S, AlMahrooqi S, AlHinai S, AlMarhoobi A, Al-Hosni S, Daar S, et al. Alloimmunization in Patients with Sickle Cell Disease and Thalassemia: Experience of a Single Centre in Oman. Mediterr J Hematol Infect Dis. 15 févr 2017;9(1):e2017013.
Nickel RS, Horan JT, Fasano RM, Meyer E, Josephson CD, Winkler AM, et al. Immunophenotypic parameters and RBC alloimmunization in children with sickle cell disease on chronic transfusion. Am J Hematol. 2015;90(12):1135‑41.
El-Beshlawy A, Salama AA, El-Masry MR, El Husseiny NM, Abdelhameed AM. A study of red blood cell alloimmunization and autoimmunization among 200 multitransfused Egyptian β thalassemia patients. Sci Rep. 3 déc 2020;10(1):21079.
Diarra AB, Guindo A, Kouriba B, Dorie A, Diabaté DT, Diawara SI, et al. Sécurité transfusionnelle et drépanocytose à Bamako, Mali. Séroprévalence des infections à VIH, VHB, VHC et allo-immunisation anti-Rh et Kell chez les drépanocytaires. Transfus Clin Biol. 1 déc 2013;20(5):476‑81.
Achargui S, Zidouh A, Abirou S, Merhfour FZ, Monsif S, Amahrouch S, et al. Identification des allo-anticorps seuls et associés : bilan de trois années au centre régional de transfusion sanguine de Rabat/Maroc et difficultés de prise en charge transfusionnelle. Transfus Clin Biol. 1 nov 2017;24(4):422‑30.
Hussein E, Desooky N, Rihan A, Kamal A. Predictors of Red Cell Alloimmunization in Multitransfused Egyptian Patients With β-Thalassemia. Arch Pathol Lab Med. 1 mai 2014;138(5):684‑8.
Wayne AS, Kevy SV, Nathan DG. Transfusion management of sickle cell disease. Blood. 1 mars 1993;81(5):1109‑23.
Dhawan HK, Kumawat V, Marwaha N, Sharma RR, Sachdev S, Bansal D, et al. Alloimmunization and autoimmunization in transfusion dependent thalassemia major patients: Study on 319 patients. Asian J Transfus Sci. déc 2014;8(2):84.
Yu Y, Ma C, Sun X, Guan X, Zhang X, Saldanha J, et al. Frequencies of red blood cell major blood group antigens and phenotypes in the Chinese Han population from Mainland China. Int J Immunogenet. août 2016;43(4):226‑35.
Gerritsma J, Bongaerts V, Eckhardt C, Heijboer H, Nur E, Biemond B, et al. Extended phenotyping does not preclude the occurrence of delayed haemolytic transfusion reactions in sickle cell disease. Br J Haematol. février 2022;196(3):769-776
Castro O, Sandler SG, Houston-Yu P, Rana S. Predicting the effect of transfusing only phenotype-matched RBCs to patients with sickle cell disease: theoretical and practical implications. Transfusion. Juin 2002;42(6):684-90. doi: 10.1046/j.1537-2995.2002.00126.x.
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