Red blood cells alloimmunization and autoimmunization among transfusion-dependent beta-thalassemia patients in Alexandria province, Egypt.

BACKGROUND: Beta thalassemia is considered a severe, progressive anemia, which needs regular transfusions for life expectancy. One of the most important complications of regular blood transfusions is autoimmunization and alloimmunization, which increases the need for transfusion. This study was performed to investigate the frequency of auto- and allo-antibodies in beta thalassemia patients in Alexandria, Egypt.

MATERIALS AND METHODS: Blood samples of fourteen beta thalassemia patients were collected and tested for autosensitization with direct antiglobulin test (DAT). The positive DAT blood sample undergone antibody elution then identification. Plasma of the patients were also investigated for allosensitization by testing against cell panel reagents.

RESULTS: DAT was positive in 45% of the patients. Eluted antibodies were identified in 6 cases of 10, they were Kp(b) and Lu(b), and one positive test was unidentified. Alloantibodies were detected in 42.5% of the cases. The identified antibodies were anti-D (4.76%), anti-c (4.76%), anti-K (4.76%), anti-Kp(a) (9.52%), anti-Kp(b) (19.05%), anti-Lu(a) (9.52%), anti-Lu(b) (19.05%), and anti-Bg(a) (4.76%). A total 23.81% of the alloantibodies were unidentified.

DISCUSSION: This study observes that autoimmunization and alloimmunization were more frequent among poly transfused beta thalassemia Egyptian patients. The presence of these clinically significant alloantibodies is a bad indicator for situation of blood transfusion. There is need for use an effective strategies to provide a safe blood for those patients by using leukodepleted blood and more compatible blood with extended phenotyping.