Red cell autoantibodies among thalassaemia patients in Hospital Universiti Sains Malaysia.

INTRODUCTION Thalassaemia is one of the major public health problems in Malaysia. Regular monthly blood transfusion remains the main treatment for severe thalassaemia patients. One of the complications of blood transfusion is the formation by the recipients of alloantibodies and autoantibodies against red blood cell (RBC) antigen. The purpose of this study was to determine the prevalence of RBC autoantibodies among multiple-transfused thalassaemic patients in our institution and factors that contribute to its development. METHODS A prospective study was conducted in Haematology Laboratory, Hospital Universiti Sains Malaysia between January 2004 and December 2004. A total of 63 thalassaemia patients, who received regular blood transfusion were included in this study. Clinical and serological data were collected and analysed prospectively. Blood samples were subjected to standard blood bank procedures for screening of antibodies and their subsequent identification using reagent of Diamed-ID Gel microtyping system. RESULTS There were 49 (77.8 percent) patients with Hb E/beta-thalassaemia, ten (15.9 percent) beta-thalassaemia major, three (4.7 percent) Hb H Constant Spring and one (1.6 percent) Hb H disease. Only one (1.6 percent) patient had autoantibodies. There were no statistical associations found between the formation of autoantibodies with age at the start of transfusion, number of packed cell transfused and splenectomy. CONCLUSION Our data showed a low autoimmunisation rate in multiple-transfused thalassaemia patients in our hospital.

[1]  B. Bain Haemoglobin and the genetics of haemoglobin synthesis , 2020, Haemoglobinopathy Diagnosis.

[2]  J. Clegg,et al.  Historical Perspectives: The Many and Diverse Routes to Our Current Understanding of the Thalassaemias , 2008 .

[3]  F. A. Bhatti,et al.  Red cell immunization in beta thalassaemia major. , 2004, Journal of the College of Physicians and Surgeons--Pakistan : JCPSP.

[4]  N. Sadek,et al.  Erythrocyte autoantibodies and expression of CD59 on the surface of red blood cells of polytransfused patients with ß-thalassaemia major , 2004, British journal of biomedical science.

[5]  S. Al-Shemmari,et al.  RBC alloimmunization and autoimmunization among transfusion‐dependent Arab thalassemia patients , 2003, Transfusion.

[6]  Y. Lau,et al.  Alloimmunization in Hong Kong southern Chinese transfusion-dependent thalassemia patients. , 2001, Blood.

[7]  G. Ferrara,et al.  Patients with neoplastic and nonneoplastic hematologic diseases acquire CTLA‐4 antibodies after blood transfusion , 2001, Transfusion.

[8]  E. Vichinsky,et al.  Alloimmunization and erythrocyte autoimmunization in transfusion-dependent thalassemia patients of predominantly asian descent. , 2000, Blood.

[9]  D. Musiani,et al.  Nuclear matrix protein is released from apoptotic white cells during cold (1‐6°C) storage of concentrated red cell units and might induce antibody response in multiply transfused patients , 2000, Transfusion.

[10]  R. Ware,et al.  Erythrocyte autoantibodies in paediatric patients with sickle cell disease receiving transfusion therapy: frequency, characteristics and significance , 1999, British journal of haematology.

[11]  D. Musiani,et al.  White cell apoptosis in packed red cells , 2008, Transfusion.

[12]  N. Tatsumi,et al.  Relation of haemolytic anaemia and erythrocyte‐bound IgG in α‐ and β‐thalassaemic syndromes , 1997 .

[13]  N. Tatsumi,et al.  Relation of haemolytic anaemia and erythrocyte-bound IgG in alpha- and beta-thalassaemic syndromes. , 1997, European journal of haematology.

[14]  Ž. Hundrić-Hašpl,et al.  Alloimmunizations following blood transfusions. , 1994, Acta medica Croatica : casopis Hravatske akademije medicinskih znanosti.

[15]  S. Singhal,et al.  Autoantibodies in thalassaemia major: relationship with oral iron chelator L1. , 1993, The Journal of the Association of Physicians of India.

[16]  V. Michail-Merianou Red Cell Alloantibodies in Patients with Thalassemia , 1992 .

[17]  S. Fucharoen,et al.  Erythroblast‐ and erythrocyte‐bound antibodies in α and β thalassaemia syndromes * , 1991 .

[18]  S. Fucharoen,et al.  Erythroblast- and erythrocyte-bound antibodies in alpha and beta thalassaemia syndromes. , 1991, Transfusion medicine.

[19]  D. Triulzi,et al.  Transfusion-induced immunomodulation and its clinical consequences. , 1990, Transfusion medicine reviews.

[20]  A. Karaklis,et al.  Alloimmunization to Red Cell Antigens in Thalassemia: Comparative Study of Usual versus Better‐Match Transfusion Programmes , 1987, Vox sanguinis.