Assessing Alloimmunization in Sickle Cell Disease Patients: Insights From a Tertiary Care Center Study on Multiple Blood Transfusion Recipients in Central India

TL;DR

This study examines the occurrence of immune reactions in sickle cell disease patients who receive multiple blood transfusions in central India.

Contribution

The study provides insights into the frequency and patterns of alloimmunization in sickle cell disease patients in a specific geographic region.

Findings

Only 3.57% of 140 patients showed antibody reactions after multiple transfusions.

Alloantibodies were primarily directed against the Rh system and were not clinically significant.

The study found no statistically significant prevalence of alloimmunization among the patients.

Abstract

Introduction: Alloimmunization is defined as a delayed transfusion reaction, which occurs days to months after transfusion, in which a patient may produce antibodies against a red cell antigen that the patient lacks. This alloimmunization process is influenced by genetic as well as acquired patient-related factors. This study aims to determine the pattern and frequency of allo-antibodies in patients with sickle cell disease (SCD) who have undergone multiple transfusions.

Material and methods: We carried out a prospective observational study at a tertiary care hospital in central India. Our focus was on patients with SCD who received multiple blood transfusions to assess their alloimmunization status by using Panoscreen® I, II, and III (Immucor, Inc., Norcross, GA) and PANOCELL 16 (Immucor, Inc.) antibody identification panel.

Results: Among 140 samples screened, five (3.57%) tested positive for antibodies. Of these, two (1.42%) had autoantibodies and three (2.15%) had alloantibodies. The prevalence of alloimmunization was not statistically significant (p = 0.418, 95% CI).

Conclusion: Alloantibodies detected were predominantly against the Rh system and not clinically significant. However, the findings highlight the need for enhanced immunohematologic testing to prevent alloimmunization and improve transfusion care in SCD patients.

Figures