Prevalence of RBC Alloimmunization and Autoimmunization among Thalassemia Patients in Jaipur
Background - Thalassemia major is a common hemoglobinopathies disorders in India. However, limited data are available
on the frequency of RBC alloimmunization and autoimmunization in transfusion dependent Jaipur thalassemia patients. The
development of anti-red blood cell antibodies (both allo-and autoantibodies) remains a major problem that is causes blood
Aim - To determine the frequency of red cell alloantibodies and autoantibodies in thalassemia patients and to identify the
Materials and Methods - A total of 48 samples were collected from thalassaemia patients at SDM Hospital. Laboratory
investigations were done by (BioVue cassettes based on Column Agglutination Technology) to all the studied patients
including: ABO, Rh blood grouping and Du testing have done, Direct Comp’s Test (DCT), Indirect Comp’s Test (ICT),
Antibodies Screening by Ortho Surgiscreen (3 cell panel), finally, specimens found positive for irregular antibody were
subjected to alloantibody and autoantibody identification using Ortho Resolve Panel A (11 cell panel).
Results - 7 patients out of total 48 patients (15%) developed alloantibodies and 4 (8%) autoantibodies. No patients have
alloantibodies with autoantibodies. The most alloantibody frequent combination was anti-M (37.5%) which is detected in 3
patients then Anti-D & Anti-E = 25% which are detected in 2 patients and Anti-C was lees one 12.5%. The most common
blood groups were AB+ & O+ (30%), eight patients of the total number of patients (11) were blood phenotyped and the most
common of Rh+K phenotype were (e &c) 34.5% but Kell was negative.
Conclusion - Several factors might have contributed to the high alloimmunization and autoimmunization rate observed in
this study, including the heterogeneity of the population living in Jaipur, lack of better-matched donors for those patients,
and the use of post storage leukodepleted blood. Antibodies screening of patients and antigen detection on RBCs of donor
specially (Rh and Kell antigen) have to do to avoid development new alloantibodies.
Keywords - Alloimmunization; Autoimmunization; Thalassemia Major; Multiple Transfusions