Frequency of Red Cell Alloimmunization in Patients with β-Major Thalassemia in an Iranian Referral Hospital
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Tehran University of Medical Sciences Press
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Objective: Frequency of red cell alloimmunization in patients with
β-major-thalassemia in Mofid children's hospital. Tehran. Iran
Material & Methods: This is a cross-sectional descriptive study
conducted in Mofid children's hospital, March 2007. A total of 121
major thalassemia patients on regular blood transfusion were included
in this study. Clinical and laboratory data were collected and analyzed
to find out the frequency, pattern and factors influencing red cell
immunization secondary to multiple blood transfusions in these
patients. Findings: Mean age of patients was 13 (6.19) from 2-26
years.They had received regular blood transfusions during periods
ranging from 1 to 25.5 years. Red cell alloimmunization was found in 9
patients (7.4%). In female group, 5 out of 66 (7.6%) patients and in
male group 4 out of 55 (7.3%) patients had evidence of
alloimmunization.The mean age of patients with alloimmunization was 9.6
(6.5) years (range 3.7-20). Four patients (44.4%) with alloimmunization
were more than 3 years old at the time of first blood transfusion. The
mean age at first blood transfusion in patients with alloimmunization
and without alloimmunization was 2.8 (2.4) and 1.7 (2.0) years (P=0.1).
The differential rate of splenectomy as a risk factor between patients
with and without alloimmunization (11.1% and8% respectively) was not
statistically significant (P=0.5). Direct or indirect antiglobulin
tests were positive in 5 (62.5%) patients. The blood alloantibodies by
a panel of antibodies using standardized blood bank methods were
detected in 4 patients, which were of anti-K and anti-D types.
Conclusion: The rate of red blood cell alloimmunization is relatively
low in our patients. The age at first blood transfusion and splenectomy
were not statistically significant as risk factors for alloimmunization
in this study.
Keywords
Thalassemia, Alloimmunization, Splenectomy
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