Alloimmunization in Egyptian children with transfusiondependent B-thalassaemia: a major challenge

Purpose B-thalassaemia is a common health issue in Egypt. However, few national studies were carried out to address the problem of alloimmunization and common alloantibodies in multitransfused thalassaemia patients. This study was designed to address those issues with the aim of optimizing the management in those patients. Patients and methods The study included 281 multitransfused B-thalassaemia Egyptian children from Delta region. Antibody screening and identification were carried out using column agglutination technology. Results Sixty-seven (23.8%) patients were found to have alloantibodies. Anti-Kell and anti-E antibodies were the most commonly encountered antibodies seen in 37.3 and 34.3% of patients, respectively. There was no significant difference in alloimmunization rate between boys and girls or between patients with thalassaemia major and intermediate. Conclusion Alloimmunization is seen in nearly a quarter of multitransfused B-thalassaemia patients. Development of red blood cell antibodies is multifactorial; however, a significant proportion of those can be prevented if pretransfusion testing involved cross-matching for the most immunogenic minor red blood cell antigens. Although this would increase the upfront cost, the long-term cost is likely to fall and is likely to improve patients’ management.