تعيين شيوع باليني و الگوي غالب پديده آلوايمونيزاسيون در بيماران تالاسمي ماژور و اينترمديت وابسته به تزريق خون در بيمارستان شفا اهواز

Determination of Clinical Prevalence and Predominant Pattern of RBCs Alloimmunization Among Transfusion Dependent Thalassemic Patients in Ahvaz

Background and Objective: The mainstay of management of severe Beta-thalassemia remains lifelong blood transfusion. The development of one or more alloantibody against specific red cell minor antigens is a common complication of chronic transfusion therapy. Delayed hemolytic transfusion reactions are due to alloantibodies cause increased blood requirement in transfusion-dependent Beta-thalassemia patients. This study was performed to detect the frequency and predominant pattern of alloimmunization in the target population. Subjects and Methods: This is a cross-sectional study carried out on 133 transfusion- dependent Beta-thalassemia patients referring to Shafa hospital-Ahvaz. Antibody screening and identification technique employed was tube method. All panel test phases were done at immunohematology laboratory of Iranian Blood Transfusion Organization. Results: Among the selected patients, 66 were males (49.1%) and 67 were females (50.9%), with a mean age of 17.63 years (SD±7.6). The antibody screening panel was positive in 42 patients (31.57%o), of whom 25 patients (59.52%) had alloantibody and 17 patients (40.50%) additionally had autoantibody. The predominant patterns of alloimmunization were anti-Rh (55%) and anti-Kell (33%>). Frequency of alloimmunization were significant with increasing duration of transfusion (P= 0.01), history of splenectomy (P=0.03) and Beta-thalassemia intermedia (P=0.02). Conclusion: Alloimmunization was a common complication in our transfusion-dependent p-thalassemia patients. Itʹs recommended that before embarking on transfusion therapy, patients should have extended red cell antigen typing that includes at least Rh and Kell blood grouping, in order to help reduce the likelihood of development of immunological responses later. Sci Med J 2010; 9(5):441-448